ArticlePloS one2018
Physician referral patterns and racial disparities in total hip replacement: A network analysis approach.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Examining Timeliness of Total Knee Replacement Among Patients with Knee Osteoarthritis in the U.S.: Results from the OAI and MOST Longitudinal Cohorts.The Journal of bone and joint surgery. American volume · 2020Pooled it
- Dissecting medical referrals in health services: role of physician professional networks.BMC health services research · 2026Article
- Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives.Journal of general internal medicine · 2025Article
- Time to Total Hip Arthroplasty Among Patients in the US Military Health System.JAMA network open · 2025Article
- A Scoping Review of Multilevel Patient-Sharing Network Measures in Health Services Research.Medical care research and review : MCRR · 2025Article
- Association of Geographic Social Vulnerability With Race-Based Differences in the Utilization of Total Hip Arthroplasty Surgeries for Medicare Beneficiaries.The Journal of arthroplasty · 2025Article
- Rural-Urban Differences in Patient-Sharing by Clinicians Caring for Children with Medical Complexity: Network Analysis of the Pediatric Workforce in Three States.The Journal of pediatrics · 2025Article
- Racial, socioeconomic, and payer status disparities in utilization of unicompartmental knee arthroplasty in the USA.Knee surgery & related research · 2025Article
- Characterizing Physician Referral Networks with Ricci Curvature.Pediatric and lifespan data science : First International Conference, IPLDSC 2024, Anaheim, CA, USA, May 23-24, 2024, Revised Selected Papers. International Pediatric and Lifespan Data Science Conference (1st : 2024 : Anaheim, Calif.) · 2025Article
- Within-Physician Differences in Patient Sharing Between Primary Care Physicians and Cardiologists Who Treat White and Black Patients With Heart Disease.Journal of the American Heart Association · 2023Article
- Infections following left ventricular assist device implantation and 1-year health-related quality of life.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Leveraging genomic diversity for discovery in an electronic health record linked biobank: the UCLA ATLAS Community Health Initiative.Genome medicine · 2022Article
- Lower Rates of Ceramic Femoral Head Use in Non-White Patients in the United States, a National Registry Study.The Journal of arthroplasty · 2022Article
- Trends and Reported Complications in Ankle Arthroplasty and Ankle Arthrodesis in the State of New York, 2009-2018.Foot & ankle orthopaedics · 2022Article
- Racial Disparities in Elective Total Joint Arthroplasty for Osteoarthritis.ACR open rheumatology · 2022Review
- Low socioeconomic status worsens access to care and outcomes for rotator cuff repair: a scoping review.JSES reviews, reports, and techniques · 2022Article
- Machine Learning Model Developed to Aid in Patient Selection for Outpatient Total Joint Arthroplasty.Arthroplasty today · 2022Article
- Variation in Provider Connectedness Associates With Outcomes of Inflammatory Bowel Diseases in an Analysis of Data From a National Health System.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Article
- Disparities across Diverse Populations in the Health and Treatment of Patients with Osteoarthritis.Healthcare (Basel, Switzerland) · 2021Review
- Where Do We Stand Today on Racial and Ethnic Health Inequities? Analysis of Primary Total Knee Arthroplasty from a 2011-2017 National Database.Journal of racial and ethnic health disparities · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundEfforts to reduce racial disparities in total hip replacement (THR) have focused mainly on patient behaviors. While these efforts are no doubt important, they ignore the potentially important role of provider- and system-level factors, which may be easier to modify. We aimed to determine whether the patterns of interaction among physicians around THR episodes differ in communities with low versus high concentrations of black residents. MATERIALS AND
methodsWe analyzed national Medicare claims from 2008 to 2011, identifying all fee-for-service beneficiaries who underwent THR. Based on physician encounter data, we then mapped the physician referral networks at the hospitals where beneficiaries' procedures were performed. Next, we measured two structural properties of these networks that could affect care coordination and information sharing: clustering, and the number of external ties. Finally, we estimated multivariate regression models to determine the relationship between the concentration of black residents in the community [as measured by the hospital service area (HSA)] served by a given network and each of these 2 network properties.
resultsOur sample included 336,506 beneficiaries (mean age 76.3 ± SD), 63.1% of whom were women. HSAs with higher concentrations of black residents tended to be more impoverished than those with lower concentrations. While HSAs with higher concentrations of black residents had, on average, more acute care beds and medical specialists, they had fewer surgeons per capita than those with lower concentrations. After adjusting for these differences, we found that HSAs with higher concentrations of black residents were served by physician referral networks that had significantly higher within-network clustering but fewer external ties.
conclusionsWe observed differences in the patterns of interaction among physicians around THR episodes in communities with low versus high concentrations of black residents. Studies investigating the impact of these differences on access to quality providers and on THR outcomes are needed.
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Registered trials
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