Rates of Knee Surgery Vary Among Medicare Population Vary By Race, Ethnicity, Region and Gender
Rates for total knee replacement surgery in the Medicare population vary significantly by race, ethnicity, region and gender, according to a study published Thursday in the New England Journal of Medicine, Long Island Newsday reports. Researchers from Dartmouth Medical School examined 430,726 Medicare fee-for-service claims for the procedure, known as arthroplasty, filed between 1998 and 2000. They found that black men, independent of region, were the least likely to receive the surgery, which is the most commonly performed joint replacement operation in the country. The study found that 4.82 white men per every 1,000 received knee replacements, while 3.46 Hispanic men and 1.84 black men per 1,000 received the surgery. It also found that the operation is performed more in some regions than in others, with the Midwest, for example, having a higher rate than the Eastern seaboard (Ricks, Long Island Newsday, 10/2). Despite blacks' and Hispanics' lower arthroplasty rates, those groups generally have higher rates of osteoarthritis, the degenerative disease that is the prime reason people undergo the procedure (Skinner et al., New England Journal of Medicine, 10/2). An abstract of the study is available online.
In an accompanying NEJM editorial, Robert Wood Johnson Foundation President and CEO Dr. Risa Lavizzo-Mourey and James Knickman, RWJF's vice president for research and evaluation, recommend three steps to follow up on the study: identifying "effective, practical approaches" that providers can use to reduce disparities; having providers, insurers and payers measure racial and ethnic disparities within the populations they treat; and having more timely data collection. Lavizzo-Mourey and Knickman conclude that the study "helps us to understand what we do and do not know," but "what is needed most right now is a comprehensive set of steps for action ... to set the nation on a path that will eliminate these disparities in health care" (Lavizzo-Mourey/Knickman, New England Journal of Medicine, 10/2). An abstract of the editorial is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.