ArticleArchives of orthopaedic and trauma surgery2023
Social determinants of health in patients undergoing hemiarthroplasty: are they associated with medical complications, healthcare utilization, and payments for care?
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Social Deprivation as a Driver of Disparities in Arthroplasty: A Contemporary Review.Current reviews in musculoskeletal medicine · 2026Review
- Impact of area deprivation index on outcomes and health care utilization following shoulder arthroplasty: a systematic review.JSES reviews, reports, and techniques · 2026Review
- Impact of neighborhood socioeconomic deprivation on implant complications after unicompartmental knee arthroplasty: a propensity-matched cohort study.Archives of orthopaedic and trauma surgery · 2026Article
- Neighborhood disadvantage predicts health resource utilization after lumbar spine surgery: a cohort study.Acta neurochirurgica · 2025Article
- The association of neighborhood-level deprivation with glioblastoma outcomes: a single center cohort study.Journal of neuro-oncology · 2025Article
- Trends and predictors of reporting social determinants of health in shoulder surgery.JSES international · 2024Article
- On the development and validation of large language model-based classifiers for identifying social determinants of health.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionSocial determinants of health (SDOH) have previously been shown to impact orthopedic surgery outcomes. This study assessed whether greater socioeconomic disadvantage in patients undergoing hemiarthroplasty following femoral neck fracture was associated with differences in (1) medical complications, (2) emergency department (ED) utilization, (3) readmission rates, and (4) payments for care.
methodsA US nationwide database was queried for hemiarthroplasties performed between 2010 and 2020. Area Deprivation Index (ADI), a validated measure of socioeconomic disadvantage reported on a scale of 0-100, was used to compare two cohorts of greater and lesser deprivation. Patients undergoing hemiarthroplasty from high ADI (95% +) were 1:1 propensity score matched to a comparison group of lower ADI (0-94%) while controlling for age, sex, and Elixhauser Comorbidity Index. This yielded 75,650 patients evenly distributed between the two cohorts. Outcomes studied were 90-day medical complications, ED utilizations, readmissions, and payments for care. Multivariate logistic regression models were utilized to calculate odds ratios (ORs) of the relationship between ADI and outcomes. p Values < 0.05 were significant.
resultsPatients of high ADI developed greater medical complications (46.74% vs. 44.97%; OR 1.05, p = 0.002), including surgical site infections (1.19% vs. 1.00%; OR 1.20, p = 0.011), cerebrovascular accidents (1.64% vs. 1.41%; OR 1.16, p = 0.012), and respiratory failures (2.27% vs. 2.02%; OR 1.13, p = 0.017) compared to patients from lower ADIs. Although comparable rates of ED visits (2.92% vs. 2.86%; OR 1.02, p = 0.579), patients from higher ADI were readmitted at diminished rates (10.57% vs. 11.06%; OR 0.95, p = 0.027). Payments were significantly higher on the day of surgery ($7,570 vs. $5,974, p < 0.0001), as well as within 90 days after surgery ($12,700 vs. $10,462, p < 0.0001).
conclusionsSocioeconomically disadvantaged patients experience increased 90-day medical complications and payments, similar ED utilizations, and decreased readmissions. These findings can be used to inform healthcare providers to minimize disparities in care. LEVEL OF EVIDENCE: III.
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