title: Total Joint Arthroplasty: A Granular Analysis of Outcomes in the Economically Disadvantaged Patient.
abstract: Poor patients experience more serious complications and worse outcomes after surgery than higher-income patients. Our objective was to study detailed patient sociodemographic characteristics and preoperative/postoperative patient-oriented outcomes in economically disadvantaged and non-economically disadvantaged primary total joint arthroplasty patients.
  
  
  
  From a consecutive series, 213 economically disadvantaged patients and 1940 non-economically-disadvantaged patients were statistically analyzed. Baseline sociodemographic characteristics and pain visual analog scale, Quality of Well-Being Index 7, Short Form 36, and Western Ontario and McMaster Universities Arthritis Index scores recorded before and after surgery were compared between both groups controlling for baseline differences. Minimum follow-up was 1 year.
  
  
  
  Economically disadvantaged patients were significantly younger, more likely to be disabled, and had worse preoperative and postoperative scores.
  
  
  
  When compared with non-economically disadvantaged patients, economically disadvantaged patients consistently had lower function and worse quality of life before and after total joint arthroplasty.
authors.affiliation: The Center for Advanced Orthopedics at Larkin Hospital, South Miami, Florida; Arthritis Surgery Research Foundation, South Miami, Florida.
authors.forename: Michele R
authors.initials: MR
authors.lastname: D'Apuzzo
authors.affiliation: Arthritis Surgery Research Foundation, South Miami, Florida.
authors.forename: Jesus M
authors.initials: JM
authors.lastname: Villa
authors.affiliation: Arthritis Surgery Research Foundation, South Miami, Florida.
authors.forename: Jose C
authors.initials: JC
authors.lastname: Alcerro
authors.affiliation: Florida International University, Miami, Florida.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Rossi
authors.affiliation: The Center for Advanced Orthopedics at Larkin Hospital, South Miami, Florida; Arthritis Surgery Research Foundation, South Miami, Florida.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Lavernia
mesh_terms: D000368:Aged; D001168:Arthritis / Q000175:diagnosis / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000191:economics; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000191:economics / Q000601:surgery*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011184:Postoperative Period; D011203:Poverty; D057234:Preoperative Period; D011788:Quality of Life; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012923:Social Class; D016896:Treatment Outcome; D014481:United States; D035862:Vulnerable Populations
keywords: Medicaid; economically disadvantaged patient; granular analysis; outcomes; total joint arthroplasty