Why the study?
Preoperative risk management programs may enforce strict cutoffs without robust care pathways, potentially worsening healthcare disparities in total joint arthroplasty for racial and ethnic minorities, women, and lower-income patients.
Do preoperative risk management programs influence healthcare disparities in adult patients undergoing elective total joint arthroplasty?
Population
Adult patients undergoing elective TJA across 24 included studies
Comparison
Preoperative risk management programs and healthcare disparities across race, ethnicity, gender, income, and insurance
Design
Systematic review of 24 articles
Key result
A review of 24 studies found that while preoperative risk management programs reduce length of stay and complications after total joint arthroplasty, strict cutoffs may worsen healthcare disparities.
Authors
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Strict cutoffs risk widening disparities in total joint arthroplasty access; challenges unnuanced optimization without equity safeguards.
Do preoperative risk management programs influence healthcare disparities in adult patients undergoing elective total joint arthroplasty?
Strict preoperative risk cutoffs for total joint arthroplasty may inadvertently widen healthcare disparities by restricting access for vulnerable populations unless accompanied by robust care navigation.
Dlott et al. (2022) conducted a review in Total Joint Arthroplasty (n=24). Preoperative risk management programs vs. Standard care or no program was evaluated on Readmissions, emergency department visits, length of stay, discharge disposition, and postoperative complications. A review of 24 studies found that while preoperative risk management programs reduce length of stay and complications after total joint arthroplasty, strict cutoffs may worsen healthcare disparities.