Chen Jie, Rizzo John A, Parasuraman Shreekant, Gunnarsson Candace
Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD 20742, USA.
J Health Care Poor Underserved. 2013 Feb;24(1):135-51. doi: 10.1353/hpu.2013.0026.
Using a nationally-representative inpatient care dataset (the HCUP National Inpatient Sample from 2002 to 2007) we examined racial disparities in receiving total hip replacement (THR) and total knee replacement (TKR) surgeries. Multivariable logistic regression models revealed that racial minorities were significantly less likely to receive THR or TKR than Whites, controlling for patients' hospital admission source and hospital characteristics. Employing Blinder-Oaxaca decomposition techniques, we found that observed difference in population characteristics explained 55%-67% and 78% of the racial disparities in THR and TKR, respectively. Differences in patients' hospital admission source emerged as the major individual factor associated with these disparities, explaining 57%-77% of racial disparities in THR and 26%-50% of racial disparities in TKR. This study suggests that substantive racial and ethnic disparities exist in utilization of THR and TKR surgery. Observed population characteristics accounted for most of these differences, with hospital admission source being the key factor.
利用一个具有全国代表性的住院护理数据集（2002年至2007年的医疗成本和利用项目国家住院样本），我们研究了在接受全髋关节置换术（THR）和全膝关节置换术（TKR）方面的种族差异。多变量逻辑回归模型显示，在控制患者的医院入院来源和医院特征后，少数族裔接受THR或TKR的可能性明显低于白人。采用布林德-奥萨克分解技术，我们发现观察到的人口特征差异分别解释了THR和TKR中55%-67%以及78%的种族差异。患者的医院入院来源差异成为与这些差异相关的主要个体因素，解释了THR中57%-77%的种族差异以及TKR中26%-50%的种族差异。这项研究表明，在THR和TKR手术的使用方面存在实质性的种族和民族差异。观察到的人口特征解释了这些差异中的大部分，其中医院入院来源是关键因素。
