Sociodemographic Disparities Seen for Outpatient Orthopedic Care
Racial/ethnic minorities, people with lower incomes, publicly insured are less likely to receive office-based care
WEDNESDAY, March 18, 2020 (HealthDay News) -- There are substantial sociodemographic disparities in the use of office-based orthopedic care and emergency department care for common, nonemergent musculoskeletal conditions, according to a study published online Feb. 21 in Clinical Orthopaedics and Related Research.
Nicholas M. Rabah, from Case Western Reserve University in Cleveland, and colleagues evaluated whether there are nationwide sociodemographic disparities in the use of either office-based orthopedic care or emergency department care for eight common, nonemergent musculoskeletal conditions (osteoarthritis, joint derangement, other joint conditions, muscle or ligament conditions, bone or cartilage conditions, foot conditions, fractures, and sprains or strains). The analysis included data from the 2007 to 2015 Medical Expenditure Panel Survey (63,514 participants; 51 percent of patients were aged 35 to 64 years; 58 percent women).
The researchers found that when controlling for age, gender, region, insurance status, income, education level, and self-reported health status, there was substantially lower use of outpatient musculoskeletal care among patients who were Hispanic (odds ratio [OR], 0.79), non-Hispanic black (OR, 0.77), less educated (OR, 0.72), of lower income (OR, 0.80), and nonprivately insured (OR, 0.85). Greater use of musculoskeletal care in the emergency department was associated with public insurance status (OR, 1.30), lower income (OR, 1.53), and lesser education status (OR, 1.35). Care for musculoskeletal conditions in the emergency department was associated with substantially greater health care expenditures than in the office-based orthopedic setting.
"Because of the lower expenditures associated with office-based orthopedic care, orthopedic surgeons should make a concerted effort to improve access to outpatient care for these populations," the authors write.