Disparity in health services and outcomes for persons with hip fracture and lower extremity joint replacement

Med Care. 2003 Feb;41(2):232-41. doi: 10.1097/01.MLR.0000044902.01597.54.


Objective: Examine disparity in health services and outcomes for adults with a hip fracture or lower extremity joint replacement.

Materials and methods: This study examined 28,522 patient records including 12,328 (mean age 76.6 years) with hip fracture and 16,194 (mean age 71.8 years) with joint replacement.

Results: Non-Hispanic white and black patients were significantly (P < 0.05) more likely to be discharged home alone and responsible for their own care than were Asian or Hispanic patients. Sixty-four percent of Hispanic patients received inpatient rehabilitation after hip fracture and 36% after hip or knee arthroplasty. In contrast, 58% of non-Hispanic white persons, 67% of black persons, and 56% of Asian persons received inpatient medical rehabilitation after hip or knee joint replacement.

Conclusion: Disparity in outcomes appeared to be related to family structure and social support.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / economics
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Caregivers / statistics & numerical data
  • Data Interpretation, Statistical
  • Databases, Factual
  • Delivery of Health Care / standards*
  • Ethnicity / statistics & numerical data*
  • Family Characteristics
  • Female
  • Health Services Accessibility
  • Hip Fractures / economics
  • Hip Fractures / rehabilitation*
  • Home Care Services / statistics & numerical data
  • Humans
  • Inpatients
  • Insurance, Health
  • Male
  • Outcome Assessment, Health Care
  • Patient Discharge
  • Patient Readmission / statistics & numerical data
  • Registries
  • Rehabilitation Centers / economics
  • Rehabilitation Centers / statistics & numerical data*
  • Reproducibility of Results
  • United States