Những yếu tố nào dẫn đến sự chênh lệch chủng tộc trong kết quả sau phẫu thuật thay khớp gối toàn bộ?

Springer Science and Business Media LLC - Tập 9 - Trang 2317-2322 - 2021
Daniel A. Hu1, James B. Hu2, Ariel Lee2, William J. Rubenstein3, Kevin M. Hwang3, Said A. Ibrahim4, Alfred C. Kuo3,5
1Northwestern University Feinberg School of Medicine, Chicago, USA
2Irvine School of Medicine, University of California, Irvine, USA
3Department of Orthopaedic Surgery, University of California, San Francisco, USA
4Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City, USA
5Orthopedic Surgery Section, San Francisco Veterans Affairs Health Care System, San Francisco, USA

Tóm tắt

Phẫu thuật thay khớp gối toàn bộ (TKA) là một trong những phẫu thuật lớn được thực hiện phổ biến nhất tại Hoa Kỳ. Trung bình, các bệnh nhân TKA người Mỹ gốc Phi trải qua kết quả lâm sàng kém hơn so với người da trắng, bao gồm mức cải thiện thấp hơn trong các kết quả tự báo cáo của bệnh nhân và tỷ lệ biến chứng, tái nhập viện, cùng phẫu thuật lại cao hơn. Các cơ chế dẫn đến những chênh lệch sức khỏe giữa các chủng tộc này vẫn chưa rõ ràng, nhưng có khả năng liên quan đến các yếu tố của bệnh nhân, nhà cung cấp dịch vụ, hệ thống chăm sóc sức khỏe và các yếu tố xã hội. Sức khỏe thể chất và tinh thần kém hơn ở mức cơ sở, hỗ trợ xã hội thấp hơn, thiên kiến của nhà cung cấp, tỷ lệ bảo hiểm y tế thấp hơn, sử dụng bệnh viện có chất lượng kém hơn và nạn phân biệt chủng tộc hệ thống có thể góp phần vào những kết quả kém mà người Mỹ gốc Phi trải nghiệm. Chứng cứ hạn chế cho thấy việc cải thiện chất lượng chăm sóc phẫu thuật có thể bù đắp cho các yếu tố này và dẫn đến việc giảm thiểu sự chênh lệch kết quả.

Từ khóa

#phẫu thuật thay khớp gối #sự chênh lệch chủng tộc #kết quả lâm sàng #sức khỏe #dịch vụ chăm sóc sức khỏe

Tài liệu tham khảo

Shahid H, Singh JA. Racial/ethnic disparity in rates and outcomes of total joint arthroplasty. Curr Rheumatol Rep. 2016;18(4):20. https://doi.org/10.1007/s11926-016-0570-3. Mehta B, Ho K, Bido J, Memtsoudis SG, Parks ML, Russell L, Goodman SM, Ibrahim S. Bilateral vs unilateral total knee arthroplasty: racial variation in utilization and in-hospital major complication rates. J Arthroplasty. 2020;S0883–5403(20):31156–66. https://doi.org/10.1016/j.arth.2020.10.057. Bass AR, McHugh K, Fields K, Goto R, Parks ML, Goodman SM. Higher total knee arthroplasty revision rates among United States Blacks than Whites: a systematic literature review and meta-analysis. J Bone Joint Surg Am. 2016;98(24):2103–8. https://doi.org/10.2106/JBJS.15.00976. Zhang W, Lyman S, Boutin-Foster C, Parks ML, Pan TJ, Lan A, Ma Y. Racial and ethnic disparities in utilization rate, hospital volume, and perioperative outcomes after total knee arthroplasty. J Bone Joint Surg Am. 2016;98(15):1243–52. https://doi.org/10.2106/JBJS.15.01009. Goodman SM, Parks ML, McHugh K, Fields K, Smethurst R, Figgie MP, Bass AR. Disparities in outcomes for African Americans and Whites undergoing total knee arthroplasty: a systematic literature review. J Rheumatol. 2016;43(4):765–70. https://doi.org/10.3899/jrheum.150950. Hinman AD, Chan PH, Prentice HA, Paxton EW, Okike KM, Navarro RA. The association of race/ethnicity and total knee arthroplasty outcomes in a universally insured population. J Arthroplasty. 2020;35(6):1474–9. https://doi.org/10.1016/j.arth.2020.02.002. Blum MA, Singh JA, Lee G-C, Richardson D, Chen W, Ibrahim SA. Patient race and surgical outcomes after total knee arthroplasty: an analysis of a large regional database. Arthritis Care Res. 2013;65(3):414–20. https://doi.org/10.1002/acr.21834. Ibrahim SA, Stone RA, Han X, Cohen P, Fine MJ, Henderson WG, Khuri SF, Kwoh CK. Racial/ethnic differences in surgical outcomes in veterans following knee or hip arthroplasty. Arthritis Rheum. 2005;52(10):3143–51. https://doi.org/10.1002/art.21304. Rubenstein WJ, Harris AHS, Hwang KM, Giori NJ, Kuo AC. Social determinants of health and patient-reported outcomes following total hip and knee arthroplasty in veterans. J Arthroplasty. 2020;35(9):2357–62. https://doi.org/10.1016/j.arth.2020.04.095. Bendich I, Zhang N, Barry JJ, Ward DT, Whooley MA, Kuo AC. Antibiotic-laden bone cement use and revision risk after primary total knee arthroplasty in U.S. veterans. JBJS. 2020;102(22):1939–47. https://doi.org/10.2106/JBJS.20.00102. Centers for Disease Control and Prevention: African American Health. Creating equal opportunities for health. www.cdc.gov/vitalsigns/aahealth/index.html. Accessed 6 Feb 2021. Everhart JS, Altneu E, Calhoun JH. Medical comorbidities are independent preoperative risk factors for surgical infection after total joint arthroplasty. Clin Orthopaed Relat Res. 2013;471(10):3112–9. https://doi.org/10.1007/s11999-013-2923-9. Hustedt JW, Goltzer O, Bohl DD, Fraser JF, Lara NJ, Spangehl MJ. Calculating the cost and risk of comorbidities in total joint arthroplasty in the United States. J Arthroplasty. 2017;32(2):355-361.e1. https://doi.org/10.1016/j.arth.2016.07.025. Elmallah RDK, Cherian JJ, Robinson K, Harwin SF, Mont MA. The effect of comorbidities on outcomes following total knee arthroplasty. J Knee Surg. 2015;28(5):411–6. https://doi.org/10.1055/s-0035-1549023. Khatib Y, Madan A, Naylor JM, Harris IA. Do psychological factors predict poor outcome in patients undergoing TKA? A systematic review. Clin Orthop Relat Res. 2015;473(8):2630–8. https://doi.org/10.1007/s11999-015-4234-9. Brander VA, Stulberg SD, Adams AD, Harden RN, Bruehl S, Stanos SP, Houle T. Predicting total knee replacement pain: a prospective, observational study. Clin Orthop Relat Res. 2003;416:27–36. https://doi.org/10.1097/01.blo.0000092983.12414.e9. Brander V, Gondek S, Martin E, Stulberg SD. Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop Relat Res. 2007;464:21–6. https://doi.org/10.1097/BLO.0b013e318126c032. McGuire TG, Miranda J. New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Aff. 2008;27(2):393–403. https://doi.org/10.1377/hlthaff.27.2.393. Barnes DM, Bates LM. Do racial patterns in psychological distress shed light on the Black-White depression paradox? A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2017;52(8):913–28. https://doi.org/10.1007/s00127-017-1394-9. Breslau J, Kendler KS, Su M, Gaxiola-Aguilar S, Kessler RC. Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychol Med. 2005;35(3):317–27. https://doi.org/10.1017/s0033291704003514. Racial/ethnic differences in mental health service use among adults | CBHSQ data. https://www.samhsa.gov/data/report/racialethnic-differences-mental-health-service-use-among-adults. Accessed 12 Oct 2020. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 2018;18(1):156. https://doi.org/10.1186/s12888-018-1736-5. Miyawaki CE. Association of social isolation and health across different racial and ethnic groups of older Americans. Ageing Soc. 2015;35(10):2201–28. https://doi.org/10.1017/S0144686X14000890. Vina ER, Cloonan YK, Ibrahim SA, Hannon MJ, Boudreau RM, Kwoh CK. Race, gender and total knee replacement consideration: the role of social support. Arthritis Care Res. 2013;65(7):1103–11. https://doi.org/10.1002/acr.21925. Groeneveld PW, Kwoh CK, Mor MK, Appelt CJ, Geng M, Gutierrez JC, Wessel DS, Ibrahim SA. Racial differences in expectations of joint replacement surgery outcomes. Arthritis Rheum. 2008;59(5):730–7. https://doi.org/10.1002/art.23565. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–14. https://doi.org/10.1016/0277-9536(91)90150-b. Lopez-Olivo MA, Landon GC, Siff SJ, Edelstein D, Pak C, Kallen MA, Stanley M, Zhang H, Robinson KC, Suarez-Almazor ME. Psychosocial determinants of outcomes in knee replacement. Ann Rheum Dis. 2011;70(10):1775–81. https://doi.org/10.1136/ard.2010.146423. Williams DR. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999;896:173–88. https://doi.org/10.1111/j.1749-6632.1999.tb08114.x. Disparities in wealth by race and ethnicity in the 2019 survey of consumer finances. [accessed 23 Jan 2021]. https://www.federalreserve.gov/econres/notes/feds-notes/disparities-in-wealth-by-race-and-ethnicity-in-the-2019-survey-of-consumer-finances-20200928.htm. Okoro CA, Zhao G, Fox JB, Eke PI, Greenlund KJ, Town M. Surveillance for health care access and health services use, adults aged 18–64 years - behavioral risk factor surveillance system, United States, 2014. MMWR Surveill Summ. 2017;66(7):1–42. https://doi.org/10.15585/mmwr.ss6607a1. Buchmueller TC, Levinson ZM, Levy HG, Wolfe BL. Effect of the affordable care act on racial and ethnic disparities in health insurance coverage. Am J Public Health. 2016;106(8):1416–21. https://doi.org/10.2105/AJPH.2016.303155. Arroyo NS, White RS, Gaber-Baylis LK, La M, Fisher AD, Samaru M. Racial/ethnic and socioeconomic disparities in total knee arthroplasty 30- and 90-day readmissions: a multi-payer and multistate analysis, 2007–2014. Popul Health Manag. 2019;22(2):175–85. https://doi.org/10.1089/pop.2018.0025. Payne BK, Vuletich HA, Brown-Iannuzzi JL. Historical roots of implicit bias in slavery. Proc Natl Acad Sci U S A. 2019; 116(24): 11693–11698. Published online 2019 May 28. https://doi.org/10.1073/pnas.1818816116. Maina IW, Belton TD, Ginzberg S, Singh A, Johnson TJ. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc Sci Med. 1982;2018(199):219–29. https://doi.org/10.1016/j.socscimed.2017.05.009. Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A systematic review of the impact of physician implicit racial bias on clinical decision making. Acad Emerg Med. 2017;24(8):895–904. https://doi.org/10.1111/acem.13214. Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, Eng E, Day SH, Coyne-Beasley T. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health. 2015;105(12):e60-76. https://doi.org/10.2105/AJPH.2015.302903. Gaskin DJ, Spencer CS, Richard P, Anderson GF, Powe NR, Laveist TA. Do hospitals provide lower-quality care to minorities than to whites? Health Aff (Millwood). 2008;27(2):518–27. https://doi.org/10.1377/hlthaff.27.2.518. Dimick J, Ruhter J, Sarrazin MV, Birkmeyer JD. Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions. Health Aff (Millwood). 2013;32(6):1046–53. https://doi.org/10.1377/hlthaff.2011.1365. Cai X, Cram P, Vaughan-Sarrazin M. Are African American patients more likely to receive a total knee arthroplasty in a low-quality hospital? Clin Orthop Relat Res. 2012;470(4):1185–93. https://doi.org/10.1007/s11999-011-2032-6. Hollenbeck B, Hoffman MA, Tromanhauser SG. High-volume arthroplasty centers demonstrate higher composite quality scores and enhanced value: perspective on higher-volume hospitals performing arthroplasty from 2001 to 2011. J Bone Joint Surg Am. 2020;102(5):362–7. https://doi.org/10.2106/JBJS.19.00139. Institute of Medicine (US) Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers. In: Ein Lewin M, Altman S, editors. America’s Health Care Safety Net: Intact but Endangered. Washington (DC): National Academies Press (US); 2000. Joynt KE, Jha AK. Characteristics of hospitals receiving penalties under the hospital readmissions reduction program. JAMA. 2013;309(4):342–3. https://doi.org/10.1001/jama.2012.94856. Lakomkin N, Hutzler L, Bosco JAI. The relationship between Medicaid coverage and outcomes following total knee arthroplasty: a systematic review. JBJS Reviews. 2020;8(4): e0085. https://doi.org/10.2106/JBJS.RVW.19.00085. National Institutes of Health; https://www.nih.gov/ending-structural-racism; accessed 28 Mar 2021. Forms of racism. Alberta Civil Liberties Research Centre. [accessed 13 Oct 2020]. http://www.aclrc.com/forms-of-racism. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–63. https://doi.org/10.1016/S0140-6736(17)30569-X. Gee GC, Ford CL. Structural racism and health inequities: old issues, new directions. Du Bois Rev. 2011;8(1):115–32. https://doi.org/10.1017/S1742058X11000130. White K, Haas JS, Williams DR. Elucidating the role of place in health care disparities: the example of racial/ethnic residential segregation. Health Serv Res. 2012;47(3 Pt 2):1278–99. https://doi.org/10.1111/j.1475-6773.2012.01410.x. Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. J Gen Intern Med. 2013;28(11):1504–10. https://doi.org/10.1007/s11606-013-2441-1. Aseltine RH Jr, Wang W, Benthien RA, Katz M, Wagner C, Yan J, Lewis CG. Reductions in race and ethnic disparities in hospital readmissions following total joint arthroplasty from 2005 to 2015. J Bone Joint Surg Am. 2019;101(22):2044–50. https://doi.org/10.2106/JBJS.18.01112. Wahl TS, Goss LE, Morris MS, Gullick AA, Richman JS, Kennedy GD, Cannon JA, Vickers SM, Knight SJ, Simmons JW, Chu DI. Enhanced recovery after surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery. Ann Surg. 2018;268(6):1026–35. https://doi.org/10.1097/SLA.0000000000002307.