Reductions in Race and Ethnic Disparities in Hospital Readmissions Following Total Joint Arthroplasty from 2005 to 2015

作者：Robert H. Aseltine, Wenjie Wang, Ross A. Benthien, Matthew H. G. Katz, Catherine Wagner, Jun Yan, Courtland G. Lewis · 发表于：Journal of Bone and Joint Surgery · 年份：2019 · DOI：10.2106/jbjs.18.01112 · 被引用次数：42 · 研究领域：Total Knee Arthroplasty Outcomes、Heart Failure Treatment and Management、Orthopaedic implants and arthroplasty

BACKGROUND: Racial and ethnic disparities in hospital readmissions following total joint arthroplasty present opportunities for reducing cost and improving health equity. Despite efforts to reduce readmissions following total joint arthroplasty in the general population, no studies have documented the impact of these efforts on racial and ethnic disparities in total joint arthroplasty readmissions. The purpose of this study was to determine whether comprehensive efforts to reduce hospital readmissions following total joint arthroplasty have impacted racial and ethnic disparities in readmission rates during the period from 2005 to 2015. METHODS: We conducted a retrospective analysis comparing patients readmitted and not readmitted to the hospital within 30 days of a total joint arthroplasty by estimating logistic regression models for clustered data using generalized estimating equations (GEEs) in R. Connecticut hospital discharge data for patients admitted for International Classification of Diseases, Ninth Revision (ICD-9) procedure codes 81.51 and 81.54 (Current Procedural Terminology [CPT] codes 27130 and 27447) during the 2005 to 2015 U.S. Centers for Medicare & Medicaid Services (CMS) fiscal years were analyzed. Models included quadratic terms to capture nonlinear time trends in readmissions, as well as terms for the statistical interaction between race or ethnicity and both the linear and quadratic time trends in predicting the odds of readmission. RESULTS: There were 1...