title: Impact of socioeconomic factors on informed decision making and treatment choice in patients with hip and knee OA.
abstract: It is unclear how socioeconomic (SES) status influences the effectiveness of shared decision making (SDM) tools. The purpose of this study was to assess the impact of SES on the utility of SDM tools among patients with hip and knee osteoarthritis (OA). We performed a secondary analysis of data from a randomized controlled trial of 123 patients with hip or knee OA. Higher education and higher income were independently associated with higher knowledge survey scores. Patients with private insurance were 2.7 times more likely than patients with Medicare to arrive at a decision after the initial office visit. Higher education was associated with lower odds of choosing surgery, even after adjusting for knowledge. Patient knowledge of their medical condition and treatment options varies with SES.
authors.affiliation: School of Medicine, University of California, San Francisco, California.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Youm
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Chan
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Belkora
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002755:Choice Behavior; D003657:Decision Making; D003661:Decision Support Techniques; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000523:psychology* / Q000628:therapy; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000628:therapy; D012923:Social Class; D055815:Young Adult
keywords: hip; informed decision making; knee; osteoarthritis; socioeconomic