Racial Disparities Exist in 90-Day Unplanned Return to the Emergency Department Following Orthopaedic Trauma Surgery

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Health Equity

Background:

• Racial disparities in healthcare outcomes are well-documented.
• Orthopaedic trauma care also exhibits these disparities, impacting patient outcomes.
• Understanding factors influencing emergency department (ED) revisits is crucial for improving care.

Purpose of the Study:

• To investigate the impact of race, social deprivation, and payor status on 90-day ED revisits in orthopaedic trauma patients.
• To identify specific demographic factors contributing to healthcare disparities in trauma care.
• To inform targeted interventions aimed at reducing ED utilization disparities.

Main Methods:

• Retrospective chart review of adult patients undergoing orthopaedic trauma surgery at a Level 1 trauma center.
• Analysis included 3120 patients treated between 2017 and 2021.
• Logistic regression models adjusted for hospital distance to assess the association between race, Area Deprivation Index, and payor status with 90-day ED revisits.

Main Results:

• Black race was significantly associated with increased odds of 90-day ED revisits (OR = 1.47).
• Medicaid coverage also showed a significant association with higher odds of ED revisits (OR = 1.63).
• Area Deprivation Index was not significantly associated with ED revisits, and the association for ethnic minority status diminished after multivariable adjustment.

Conclusions:

• The study confirms significant racial and socioeconomic disparities in ED utilization post-orthopaedic trauma.
• Black patients and those with Medicaid coverage face higher odds of returning to the ED.
• Further research is needed to understand the underlying causes and develop interventions to mitigate these disparities.