Racial differences in expectations of joint replacement surgery outcomes.

Authors

• Peter W Groeneveld
• C Kent Kwoh
• Maria K Mor
• Cathleen J Appelt
• Ming Geng
• Jennifer C Gutierrez
• Damaris S Wessel
• Said A Ibrahim

Publication/Presentation Date

5-15-2008

Abstract

OBJECTIVE: Prior studies have indicated racial differences in patients' expectations for joint replacement surgery outcomes. The goal of this study was to measure these differences using a well-validated survey instrument and to determine if the differences could be explained by racial variation in disease severity, socioeconomic factors, literacy, or trust.

METHODS: Detailed demographic, clinical, psychological, and social data were collected from 909 male patients (450 African American, 459 white) ages 50-79 years with moderate or severe osteoarthritis (OA) of the hip or knee receiving primary care at 2 veterans affairs medical centers. The previously validated Joint Replacement Expectations Survey was used to assess expectations for pain relief, functional improvement, and psychological well-being after joint replacement.

RESULTS: Among knee OA patients (n = 627), the unadjusted mean expectation score (scale 0-76) for African American patients was 48.7 versus 53.6 for white patients (mean difference 4.9, P < 0.001). For hip OA patients (n = 282), the unadjusted mean expectation score (scale 0-72) for African Americans was 45.4 versus 51.5 for whites (mean difference 6.1, P < 0.001). Multivariable adjustment for disease severity, socioeconomic factors, education, social support, literacy, and trust reduced these racial differences to 3.8 points (95% confidence interval [95% CI] 1.2, 6.3) among knee OA patients and 4.2 points (95% CI 0.4, 8.0) among hip patients.

CONCLUSION: Among potential candidates for joint replacement, African American patients have significantly lower expectations for surgical outcomes than white patients. This difference is not entirely explained by racial differences in demographics, disease severity, education, income, social support, or trust.

Volume

59

Issue

5

First Page

730

Last Page

737

ISSN

0004-3591

Published In/Presented At

Groeneveld, P. W., Kwoh, C. K., Mor, M. K., Appelt, C. J., Geng, M., Gutierrez, J. C., Wessel, D. S., & Ibrahim, S. A. (2008). Racial differences in expectations of joint replacement surgery outcomes. Arthritis and rheumatism, 59(5), 730–737. https://doi.org/10.1002/art.23565

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

18438917

Department(s)

Administration and Leadership

Document Type

Article