Does rural residence impact total ankle arthroplasty utilization and outcomes?

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Public Health

Background:

• Total ankle arthroplasty (TAA) is a procedure for end-stage ankle arthritis.
• Understanding utilization and outcomes based on patient residence is crucial for equitable healthcare.
• Previous research has not fully elucidated rural-urban disparities in TAA.

Purpose of the Study:

• To compare total ankle arthroplasty (TAA) utilization and patient outcomes between rural and urban residents.
• To identify any rural-urban disparities in TAA access and post-operative results.

Main Methods:

• Analysis of the Nationwide Inpatient Sample (NIS) database from 2003 to 2011.
• Comparison of TAA utilization rates and outcomes (discharge disposition, length of stay, mortality) between rural and urban populations.
• Utilized multivariable-adjusted logistic regression to control for confounding factors.

Main Results:

• In 2003, rural-urban disparities in TAA utilization were observed, but these differences were not significant by 2011.
• No significant differences were found in TAA outcomes, including discharge disposition, length of hospitalization, or mortality, between rural and urban patients.
• Logistic regression models confirmed the absence of significant rural-urban differences in key TAA outcomes.

Conclusions:

• This study demonstrates an absence of evidence for rural-urban differences in total ankle arthroplasty outcomes.
• While initial utilization disparities in TAA existed, they resolved by 2011, suggesting improving equity in access.
• TAA care appears to be equitable regarding outcomes, irrespective of patient residence in rural or urban areas.