Evidence map›Paper›PMID 41070372›Full record

ArticleJB & JS open access

Disparities in Patient-Reported Healthcare Affordability and Access Among Arthroplasty Patients in the All of Us Database.

Michael J Farias, Theodore Joaquin, Gabriel Gonzalez, Yuchen Hua, Manjot Singh, Joseph E Nassar, Lachlan Kirby, Zvipo M Chisango, Nicolas L Carayannopoulos, Catherine B Hurley and 2 more

Abstract read
In one paragraph

Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Michael J FariasWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0000-0002-9705-1351
Theodore JoaquinWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0002-2474-7857
Gabriel GonzalezWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0002-0578-9461
Yuchen HuaData Science Institute, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0006-1758-6492
Manjot SinghWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0000-0003-4524-6226
Joseph E NassarWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0000-0002-2475-4996
Lachlan KirbyWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0002-2985-036X
Zvipo M ChisangoWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0008-8977-8375
Nicolas L CarayannopoulosWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0005-9978-3715
Catherine B HurleyWarren Alpert Medical School, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0009-0004-2766-5149
Bassel G DieboDepartment of Orthopedics, Brown University, Providence, Rhode Island.
Alan H DanielsDepartment of Orthopedics, Brown University, Providence, Rhode Island.ORCID https://orcid.org/0000-0001-9597-4139

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: While racial and ethnic disparities in postoperative outcomes for total hip and knee arthroplasty (THA/TKA) are well-documented, a significant gap remains in understanding patient-reported barriers to care. This study investigates racial and ethnic disparities in self-reported barriers to health care among THA/TKA patients. Methods: This cross-sectional study used data from the All of Us Research Program. Adult patients undergoing THA or TKA were identified using Current Procedural Terminology codes. Multivariable logistic regression was used to analyze 11 self-reported barriers across racial/ethnic groups (non-Hispanic White, Black, Hispanic, and Other). Odds ratios (ORs) were calculated from models after adjusting for age, sex, and/or neighborhood-level Community Deprivation Index (CDI). Results: A total of 4,419 patients were analyzed: 3,706 (83.9%) White, 325 (7.4%) Black, 235 (5.3%) Hispanic, and 153 (3.5%) Other. After adjusting for age, sex, and CDI, Black patients had significantly higher odds of delaying care because of cost of follow-up (OR 2.01, 95% confidence interval [CI] 1.26-3.21), general visits (OR 2.07, 95% CI 1.24-3.47), and co-pays (OR 2.31, 95% CI 1.44-3.71). Both Black (OR 1.99, 95% CI 1.32-2.98) and Hispanic (OR 1.79, 95% CI 1.13-2.82) patients had significantly higher odds of experiencing transportation-related delays. Conclusion: Significant racial and ethnic disparities in affordability and access persist among THA/TKA patients, even after controlling for neighborhood-level socioeconomic deprivation. Black and Hispanic patients experience multifaceted barriers, underscoring that interventions should address not only individual patient circumstances but also structural community-level factors to achieve equitable arthroplasty care. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

Identifiers

PMID41070372
PMCPMC12503140

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.