Hispanic vs. Non-Hispanic disparities in discharge destination after outpatient total knee arthroplasty (TKA)
Introduction: Discharge destination plays an important role in care coordination and costs following outpatient TKA. Understanding factors influencing discharge destination after TKA is critical. This study examined racial/ethnic disparities in discharge destination among TKA patients from a large, predominantly Hispanic, metropolitan U.S. area.
Methods: We retrospectively analyzed TKA patients admitted between January 01, 2018 and August 01, 2018. Discharge destination to either home, home with home health care, skilled nursing facility, or other institution was compared between patients of White Hispanic race/ethnicity and those of White Non-Hispanic race/ethnicity using Pearson’s chi-square. Differences between groups in age, sex, insurance type, preoperative education, anesthesia type, smoking, body mass index, diabetes, cardiovascular disease, and kidney dis-ease were also compared using 2-tailed t -tests for continuous data, and Pearson’s chi-square or Fischer exact tests for categorical data. Analyses were conducted on SPSS (IBM, version 23.0).
Results: We identified 422 TKA patients: 262 (62.1%) were White Hispanic and 160 (37.9%) were White Non-Hispanic. Discharge destination was significantly different between groups ( p =0.028). White Hispanic patients were more likely to be discharged to a skilled nursing facility (11.8% vs. 3.8%) compared to White Non-Hispanic patients. Following were the observed rates of discharge for White Hispanic compared to White Non-Hispanic, respectively, to: home (52.7% vs. 56.9%), home with home health care (31.3% vs. 32.5%), and other institution (4.2% vs. 6.9%). No significant differences in demographics or comorbidities were noted between groups.
Conclusion: White Hispanic TKA patients were more likely to be discharged to a skilled nursing facility compared to White Non-Hispanic patients, despite showing no significant differences demographic characteristics or comorbidities. These findings are consistent with data on other minority populations. Factors underlying this association warrant investigation to help increase rates of discharge to home.
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Arguelles, William; Paraliticci, Giovanni; and Suarez, Juan Carlos, "Hispanic vs. Non-Hispanic disparities in discharge destination after outpatient total knee arthroplasty (TKA)" (2019). All Publications. 3303.