New Study Finds Black Patients Less Likely to be Completely Satisfied with Care After Knee or Hip Replacement
A study presented today at the American Academy of Orthopaedic Surgeons (AAOS) 2022 Annual Meeting found that Black patients were less likely than white patients to be completely satisfied with the process of care following knee or hip replacement. Socioeconomic status was not found to play a role in patient satisfaction.
“Patient satisfaction related to the hospital experience following surgery is an important aspect of patient care,” said Susan M. Goodman, MD, a rheumatologist at Hospital for Special Surgery (HSS) and senior investigator. “The Press Ganey inpatient survey is commonly administered to patients to assess their satisfaction with the process of care. Our aim was to determine whether overall patient assessment scores differed by race or socioeconomic status.”
Dr. Goodman and a team of researchers reviewed the Press Ganey survey responses of more than 4,600 patients who had surgery at HSS from July 2010 to February 2012. Individuals having a primary knee or hip replacement who resided in New York, New Jersey or Connecticut were included in the study.
Researchers analyzed the data to establish an overall score, calculated as the mean of a patient’s ratings for three questions in the “Overall Assessment” section of the Press Ganey survey. The results were categorized as either “completely satisfied” (score of 100) or “not completely satisfied” (score <100).
The analysis, which included 2,516 individuals who underwent hip replacement and 2,113 who had a knee replacement, found that Black patients were more likely to indicate they were “not completely satisfied” compared to white patients in both joint replacement groups.
Dr. Goodman said that although Black patients indicated they were less satisfied with the process of care right after surgery, there was no difference in satisfaction with their joint replacement outcome. Factors such as pain and function are part of the outcome assessment, which is generally conducted two years after surgery.
With respect to socioeconomic status, researchers considered the patient’s primary health insurance coverage. The study found that the individual’s primary payor was not associated with satisfaction in either joint replacement group.
“The study is important because we know that Black patients generally wait longer to seek treatment, presenting with worse pain and function prior to surgery, and we are trying to sort out the barriers to seeking timely care,” said Mark P. Figgie, MD, chief emeritus of the Surgical Arthritis Service at HSS and co-author of the study.
“Patient outcome measures indicate that although Black patients achieve significant improvement after surgery, it does not reach the same level as those who seek timely treatment,” he added. “Confidence in the health care system may contribute to the delay in seeking care, and this is something we need to address.”
Dr. Goodman added, “More research is needed to investigate other factors, such as perceived staff courtesy and baseline pain and function, to understand why disparities exist so we can achieve a high level of patient satisfaction for everyone.”
Authors: Anne R. Bass, MD, Emily Ying LAI, MSc, Huong Do, MA (HSS), John A. Gibbons, BA, Letitia Bradford, MD, FAAOS, FACS (Nth Dimensions), Mark P. Figgie, MD, Michael L. Parks, MD (HSS), Orett Burke, BS (Rutgers Robert Wood Johnson Medical School), Susan M. Goodman, MD (HSS).
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.