Public Insurance and Language Preferences Are Associated With a Longer Time to Surgery for Distal Radius Fractures

Area of Science:

• Orthopaedic surgery
• Health services research
• Health equity

Background:

• Insurance type influences access to specialist orthopaedic care.
• Disparities in care access can lead to delayed treatment for orthopaedic conditions.
• Distal radius fractures requiring surgery are common injuries.

Purpose of the Study:

• To quantify the impact of insurance type on the time to surgery for distal radius fractures.
• To identify factors contributing to delays in surgical treatment for these fractures.
• To investigate potential disparities in orthopaedic care delivery based on insurance status.

Main Methods:

• Retrospective cohort study of adult patients with surgically managed distal radius fractures.
• Analysis of time from injury to surgery, injury to clinic visit, and clinic visit to surgery.
• Linear regression models used to analyze time intervals and associated factors.

Main Results:

• Public insurance patients experienced significantly longer times from injury to surgery (16.2 days) compared to private insurance patients (11.0 days).
• The primary driver of delay for publicly insured patients was a longer time from injury to clinic visit.
• Younger patients and those preferring languages other than English faced greater delays in surgical treatment.

Conclusions:

• Public insurance is associated with increased time to surgery for distal radius fractures.
• Younger patients and non-English speakers experience more pronounced delays, highlighting systemic inequities.
• System-level interventions are needed to address and mitigate these disparities in orthopaedic care.