Study: Low-Income Patients Less Likely to Have Joint Replacement Surgery

Low-income arthritis patients have a much higher rate of knee and hip problems but are only have as likely to have joint replacement surgery as patients with higher incomes, according to researchers at the University of Toronto.

In their study reported in the journal Arthritis and Rheumatism, researchers assessed the effect of education and income on the potential need for, and the willingness to consider hip and knee joint repair surgery.

A total of 48,218 adults, ages 55 and older, were surveyed by mail or telephone and a group of 3,307 people with moderate-to-severe hip/knee problems were identified. These people received a questionnaire to assess education, income, arthritis severity, and other illnesses. In a group taken from these subjects, researchers conducted interviews to evaluate the willingness to consider joint repair surgery, and also performed clinical and x-ray examinations of the joints to validate the self-reports of arthritis.

Less education and lower income were independently associated with a greater likelihood of having the potential need for joint repair surgery. Among the subjects with potential need, neither education nor income was independently associated with a definite willingness to consider the surgery. Therefore, taking willingness into consideration, individuals with less education and/or lower income were more likely to have potential unmet need for joint repair surgery.

"Persons with lower socioeconomic status had a greater need for, and were equally willing to consider arthroplasty, compared with those with higher socioeconomic status. Thus, observed socioeconomic status disparities in the rates of performed arthroplasties cannot be explained by a lower need or less willingness to undergo arthroplasty in those with lower socioeconomic status," concluded the authors.

Other sources: Arthritis and Rheumatism