{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:01:16Z","timestamp":1794002476456,"version":"4.8.0"},"reference-count":36,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013331","name":"American Society of Anesthesiologists","doi-asserted-by":"publisher","award":["Diversitymentoringgrant"],"award-info":[{"award-number":["Diversitymentoringgrant"]}],"id":[{"id":"10.13039\/100013331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013331","name":"American Society of Anesthesiologists","doi-asserted-by":"publisher","award":["2020"],"award-info":[{"award-number":["2020"]}],"id":[{"id":"10.13039\/100013331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Abundant literature acknowledges healthcare disparities exist in medicine, especially in pain management, but disparities related to peri-operative pain management in veterans undergoing total knee arthroplasties (TKA) has not been previously described. TKAs are becoming increasingly common, and evidence suggests that perioperative regional anesthesia improves post TKA outcomes. This study aimed to determine if healthcare disparities exist pertaining to the use of regional anesthesia and the prescribing of discharge opioids for TKAs in the Veterans Affairs Health Care System (VAHCS). We hypothesized that race-based disparities would be present in the use of regional anesthesia and discharge opioid prescribing at our institution. Our secondary hypothesis was that older patients would be more likely to receive regional anesthesia and lower quantities of opioids at discharge.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    This was a retrospective analysis of Atlanta VAHCS patients who underwent elective unilateral primary or revision TKA surgery between 2014 and 2020. A total of 653 patients were included. Multivariate logistic regression was used to model the impact of patient demographics on nerve block use and multivariate linear regression was used to model the impact of patient demographics on total oral morphine equivalents prescribed.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    \u00a0Our results showed that Black patients were as likely to receive regional anesthesia for their TKAs (p=0.85) but did receive less opioid pain medications at discharge (p&lt;0.001) than White patients. We also found that older patients (\n                    <ns4:underline>&gt;<\/ns4:underline>\n                    50 years old) had significantly lower odds ratio of receiving regional anesthesia and received less opioid pain medications post TKA discharge.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Our study showed age-based disparities in regional anesthesia utilization and discharge opioid prescriptions. It also showed race-based disparities in discharge opioid prescriptions.\u00a0 Our results demonstrate the need to better understand why these differences exist within this open access system and suggests solutions based on the socioecological model to diminish them.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.139684.1","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T12:30:08Z","timestamp":1699446608000},"page":"1451","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Retrospective study of disparities in regional anesthesia and discharge opioid prescriptions at a veterans affairs medical center"],"prefix":"10.12688","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9224-0655","authenticated-orcid":false,"given":"Mercy A.","family":"Udoji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwatoyin","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangqin","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Glas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-6049","authenticated-orcid":false,"given":"Anna","family":"Woodbury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.1016\/j.ogc.2016.10.001","article-title":"Racial and Ethnic Disparities in Health and Health Care.","volume":"44","author":"S Wheeler","year":"2017","journal-title":"Obstet. 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Surg."},{"key":"ref40","article-title":"Opioid Morphine EQ Conversion."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T03:55:11Z","timestamp":1735530911000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,8]]},"references-count":36,"URL":"https:\/\/doi.org\/10.12688\/f1000research.139684.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.152981.r306079","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.152981.r306080","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.152981.r306079","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.152981.r306080","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,8]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.152981.r306079, Alethia Sellers, Anesthesiology and Perioperative Medicine, The University of Alabama at Birmingham Department of Medicine (Ringgold ID: 164494), Birmingham, Alabama, 21 Aug 2024, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1#referee-response-306079","order":0,"name":"referee-response-306079","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.152981.r306080, Channing Twyner, University of Mississippi Medical Center, Jackson, MS, 30 Dec 2024, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/12-1451\/v1#referee-response-306080","order":1,"name":"referee-response-306080","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was supported by the American Society of Anesthesiologists Diversity Mentoring Grant, 2020.\n\nDisclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}