The Root of The Problem
To address health disparities, we need to understand why they exist. Health disparities are not due to one single factor. They’re the result of policy decisions we make as a community. They’re due to the environment, health education, insurance and access to care, access to healthy food and stress. Those stresses are experienced disproportionately by people who are poor, and people who have been historically disadvantaged in this society. Many studies find minority patients in the United States are less likely to get a surgical replacement procedure for their knees. Though they are more likely to have complications when they do get the surgery.
More than 600,000 total knee replacements (TKR) are done in the US each year, but even after adjusting certain patient demographics, socioeconomic status and healthcare system characteristics, significant racial disparities in total knee replacement exist. Of the groups of patients studied, 87 percent were whites, nearly 6 percent were African Americans and 4 percent were Hispanic. The researchers find that minority patients are less likely to undergo the surgery in hospitals that do large numbers of TKR. They also find that black Native American and mixed-race patients have significantly higher rates of complications and in hospital deaths.
Another factor that many studies have found is that black patients do not get surgical procedure referral as frequently by their doctor as compared to white patients. Even though TKR is an elective procedure, physicians often fail to mention this option to their non-white patients. As a result, African American and other non-white patients are not well-informed about all of the treatment options for osteoarthritis. Due to all of these factors, African American patients lose a huge number of quality-adjusted life years (or QALY’s).
The More the Patients Are Well-Informed About Their Treatment Options, The More QALY’S They Gain
A lot of times, doctors do have limited amount of time when they see you, even though they discuss your medical condition with you, sometimes they make decisions for you. But, it’s your right to ask them questions. Patient education is important because everyone should be well-informed about their disease or illness, all of the available treatment options and their risks and benefits to take in consideration.
Only when a patient fully understands and is wellinformed, they can ask their doctor about any treatment related concerns and decide which treatment option they want to have. If you have chronic knee pain, you should take charge and responsibility to speak to your doctor about your available options.
Doctors are there to give you their best medical recommendation; however, it is your decision to make and choose which treatment option you’re going to take. It is recommended for African American patients to not only consult with your doctor about the TKR option but also request that you would like to be referred to an orthopedic surgeon who specializes and performs TKR surgeries in a high-volume healthcare facility.
It has been shown that African American whose TKR surgeries were performed by a TKR specialized surgeon at a high-volume hospital had a higher rate of success and a lower rate of postsurgical complications.