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Disparities in Access to Robotic Knee Arthroplasty: A Geospatial Analysis
Nicholas J Peterman1, Nicholas Pagani2, Rachel Mann1
1Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois.
The Journal of Arthroplasty
|October 18, 2023
Summary
Robotic knee arthroplasty (RKA) access is not uniform across the US. Geospatial analysis reveals significant geographic disparities, with rural and lower-income populations facing greater access challenges for this advanced surgical procedure.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Geospatial Health Analysis
Background:
- Robotic knee arthroplasty (RKA) utilization is increasing nationwide.
- Geospatial analysis is crucial to understand RKA distribution and patient access.
- Existing literature suggests potential disparities in healthcare access.
Purpose of the Study:
- To determine if robotic knee arthroplasty (RKA) is uniformly distributed across the United States.
- To identify geographic disparities in patient access to RKA.
- To analyze the relationship between RKA access and sociodemographic factors.
Main Methods:
- Utilized provider-finding functions from 5 RKA system manufacturers to map surgeon locations.
- Calculated average travel distances to the nearest RKA surgeon per county.
- Employed Moran's index for hotspot/coldspot analysis and logistic regression for sociodemographic correlations.
Main Results:
- Hotspots for RKA access were concentrated in the West South Central and West North Central regions.
- These hotspots were significantly more rural, with predominantly White populations, lower median incomes, and less health insurance coverage.
- Analysis identified 2,571 surgeons with RKA access out of 34,216 practicing orthopedic surgeons in 2022.
Conclusions:
- Geographic access disparities for RKA exist, disproportionately affecting rural and economically disadvantaged populations.
- Absolute access disparities are evident, with relative access disparities persisting for minority populations in urban areas.
- Findings align with existing literature on healthcare access inequalities.
