Patient Health Care Disparities in Shoulder Arthroplasty

Shoulder arthroplasty (SA) is an effective surgical procedure to treat advanced degenerative conditions of the shoulder as well as tumors or fractures of the proximal humerus. Utilization of SA is increasing in the United States as indications have expanded, however, health care disparities around utilization and clinical outcomes following SA also exist. This review examines current literature on patient related health care disparities in SA.

Within SA, patient related health care disparities are highly influenced by race, ethnicity, socioeconomic status, geography, and patient sex. Short term clinical outcomes show that Non-White patients experience lower utilization of SA, longer hospital stays, higher complications, and increased readmissions. Sex related disparities demonstrate that female patients have a longer interval between initial consultation and surgery. Additionally, females experience lower functional scores and higher rates of perioperative fractures than males. In the current era of value-based care, wide disparities in early postoperative outcomes increase the cost of healthcare to both patients and health systems. Disparities in SA remain underexplored compared to other health topics. Existing literature highlights suboptimal outcomes in racially, ethnically, or socially disadvantaged groups. Active awareness and recognition of healthcare disparities are required to renew and strengthen initiatives to deliver more equitable care after SA.