{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:07:21Z","timestamp":1790647641538,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,5,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite declines in both the incidence of and mortality following hip fracture, there are racial and socioeconomic disparities in treatment access and outcomes. We evaluated the presence and implications of disparities in delivery of care, hypothesizing that race and community socioeconomic characteristics would influence quality of care for patients with a hip fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We collected data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS), which prospectively captures information on all discharges from nonfederal acute-care hospitals in New York State. Records for 197,290 New York State residents who underwent surgery for a hip fracture between 1998 and 2010 in New York State were identified from SPARCS using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Multivariable regression models were used to evaluate the association of patient characteristics, social deprivation, and hospital\/surgeon volume with time from admission to surgery, in-hospital complications, readmission, and 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After adjusting for patient and surgery characteristics, hospital\/surgeon volume, social deprivation, and other variables, black patients were at greater risk for delayed surgery (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.42, 1.57), a reoperation (hazard ratio [HR] = 1.21; CI = 1.11, 1.32), readmission (OR = 1.17; CI = 1.11, 1.22), and 1-year mortality (HR = 1.13; CI = 1.07, 1.21) than white patients. Subgroup analyses showed a greater risk for delayed surgery for black and Asian patients compared with white patients, regardless of social deprivation. Additionally, there was a greater risk for readmission for black patients compared with white patients, regardless of social deprivation. Compared with Medicare patients, Medicaid patients were at increased risk for delayed surgery (OR = 1.17; CI = 1.10, 1.24) whereas privately insured patients were at decreased risk for delayed surgery (OR = 0.77; CI = 0.74, 0.81), readmission (OR = 0.77; CI = 0.74, 0.81), complications (OR = 0.80; CI = 0.77, 0.84), and 1-year mortality (HR = 0.80; CI = 0.75, 0.85).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There are race and insurance-based disparities in delivery of care for patients with hip fracture, some of which persist after adjusting for social deprivation. In addition to investigation into reasons contributing to disparities, targeted interventions should be developed to mitigate effects of disparities on patients at greatest risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00676","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T15:04:21Z","timestamp":1463583861000},"page":"858-865","source":"Crossref","is-referenced-by-count":175,"title":["Racial and Socioeconomic Disparities in Hip Fracture Care"],"prefix":"10.2106","volume":"98","author":[{"given":"Christopher J.","family":"Dy","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery (J.M.L. and M.L.P.) and Healthcare Research Institute (J.M.L., T.J.P., M.L.P., and S.L.), Hospital for Special Surgery, New York, NY"},{"name":"Weill Cornell Medical College, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting Jung","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery (J.M.L. and M.L.P.) and Healthcare Research Institute (J.M.L., T.J.P., M.L.P., and S.L.), Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Parks","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery (J.M.L. and M.L.P.) and Healthcare Research Institute (J.M.L., T.J.P., M.L.P., and S.L.), Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Lyman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery (J.M.L. and M.L.P.) and Healthcare Research Institute (J.M.L., T.J.P., M.L.P., and S.L.), Hospital for Special Surgery, New York, NY"},{"name":"Weill Cornell Medical College, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"3","key":"bib1-20230714","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1359\/jbmr.061113","article-title":"Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025","volume":"22","author":"Burge","year":"2007","journal-title":"J Bone Miner Res."},{"issue":"14","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1001\/jama.2009.1462","article-title":"Incidence and mortality of hip fractures in the United States","volume":"302","author":"Brauer","year":"2009","journal-title":"JAMA."},{"issue":"3","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1177\/0898264313516994","article-title":"Trends in the utilization and outcomes of Medicare patients hospitalized for hip fracture, 2000-2008","volume":"26","author":"Becker","year":"2014","journal-title":"J Aging Health."},{"issue":"8","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1093\/gerona\/63.8.860","article-title":"Race\/ethnicity and outcomes following inpatient rehabilitation for hip fracture","volume":"63","author":"Graham","year":"2008","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"4","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/MLR.0b013e3181ca4126","article-title":"Nonoperative care for hip fracture in the elderly: the influence of race, income, and comorbidities","volume":"48","author":"Neuman","year":"2010","journal-title":"Med Care."},{"issue":"8","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1093\/gerona\/63.8.867","article-title":"The association of race, gender, and comorbidity with mortality and function after hip fracture","volume":"63","author":"Penrod","year":"2008","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"6","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1302\/0301-620X.93B6.24936","article-title":"The influence of socioeconomic status on the incidence, outcome and mortality of fractures of the hip","volume":"93","author":"Quah","year":"2011","journal-title":"J Bone Joint Surg Br."},{"issue":"7418","key":"bib8-20230714","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/bmj.327.7418.771","article-title":"Time trends and demography of mortality after fractured neck of femur in an English population, 1968-98: database study","volume":"327","author":"Roberts","year":"2003","journal-title":"BMJ."},{"issue":"7","key":"bib9-20230714","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1007\/s11999-010-1736-3","article-title":"Gender and race\/ethnicity differences in hip fracture incidence, morbidity, mortality, and function","volume":"469","author":"Sterling","year":"2011","journal-title":"Clin Orthop Relat Res."},{"issue":"11","key":"bib10-20230714","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1007\/s00198-007-0429-6","article-title":"Excess mortality following hip fracture: the role of underlying health status","volume":"18","author":"Tosteson","year":"2007","journal-title":"Osteoporos Int."},{"issue":"8","key":"bib11-20230714","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.2105\/AJPH.82.8.1147","article-title":"Race and sex differences in mortality following fracture of the hip","volume":"82","author":"Jacobsen","year":"1992","journal-title":"Am J Public Health."},{"issue":"8","key":"bib12-20230714","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.2105\/AJPH.84.8.1287","article-title":"Treatment and survival among elderly Americans with hip fractures: a population-based study","volume":"84","author":"Lu-Yao","year":"1994","journal-title":"Am J Public Health."},{"issue":"4","key":"bib13-20230714","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1007\/s11999-013-3416-6","article-title":"Risk factors for revision within 10 years of total knee arthroplasty","volume":"472","author":"Dy","year":"2014","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0895-4356(92)90133-8","article-title":"Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases","volume":"45","author":"Deyo","year":"1992","journal-title":"J Clin Epidemiol."},{"issue":"5","key":"bib15-20230714","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis."},{"issue":"7","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2105\/AJPH.93.7.1137","article-title":"Area deprivation and widening inequalities in US mortality, 1969-1998","volume":"93","author":"Singh","year":"2003","journal-title":"Am J Public Health."},{"issue":"10","key":"bib19-20230714","doi-asserted-by":"crossref","first-page":"e46175","DOI":"10.1371\/journal.pone.0046175","article-title":"Timing matters in hip fracture surgery: patients operated within 48 hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients","volume":"7","author":"Moja","year":"2012","journal-title":"PLoS One."},{"issue":"6","key":"bib20-20230714","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1097\/SLA.0000000000000326","article-title":"Disparities in surgical 30-day readmission rates for Medicare beneficiaries by race and site of care","volume":"259","author":"Tsai","year":"2014","journal-title":"Ann Surg."},{"issue":"2","key":"bib21-20230714","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1359\/JBMR.041007","article-title":"Osteoporosis and fracture risk in women of different ethnic groups","volume":"20","author":"Barrett-Connor","year":"2005","journal-title":"J Bone Miner Res."},{"issue":"12","key":"bib22-20230714","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1359\/jbmr.090528","article-title":"Application of high-resolution skeletal imaging to measurements of volumetric BMD and skeletal microarchitecture in Chinese-American and white women: explanation of a paradox","volume":"24","author":"Walker","year":"2009","journal-title":"J Bone Miner Res."},{"issue":"6","key":"bib23-20230714","doi-asserted-by":"crossref","first-page":"e321","DOI":"10.2106\/JBJS.K.00631","article-title":"The relationship between social deprivation and the incidence of adult fractures","volume":"95","author":"Court-Brown","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib24-20230714","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s00198-010-1287-1","article-title":"Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly","volume":"22","author":"Guilley","year":"2011","journal-title":"Osteoporos Int."},{"issue":"10","key":"bib25-20230714","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/aje\/kwp266","article-title":"The aftermath of hip fracture: discharge placement, functional status change, and mortality","volume":"170","author":"Bentler","year":"2009","journal-title":"Am J Epidemiol."},{"issue":"3","key":"bib27-20230714","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/1475-6773.12150","article-title":"The Medicare Hospital Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations","volume":"49","author":"Gu","year":"2014","journal-title":"Health Serv Res."},{"issue":"3","key":"bib28-20230714","doi-asserted-by":"crossref","first-page":"w405","DOI":"10.1377\/hlthaff.26.3.w405","article-title":"Will pay-for-performance and quality reporting affect health care disparities?","volume":"26","author":"Casalino","year":"2007","journal-title":"Health Aff (Millwood)."},{"issue":"26","key":"bib29-20230714","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1056\/NEJMp1312654","article-title":"Will value-based purchasing increase disparities in care?","volume":"369","author":"Ryan","year":"2013","journal-title":"N Engl J Med."},{"issue":"10","key":"bib30-20230714","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1377\/hlthaff.2013.0194","article-title":"Despite overall improvement in surgical outcomes since 2000, income-related disparities persist","volume":"32","author":"Qasim","year":"2013","journal-title":"Health Aff (Millwood)."},{"issue":"2","key":"bib31-20230714","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1001\/archinte.167.2.182","article-title":"Neighborhoods matter: use of hospitals with worse outcomes following total knee replacement by patients from vulnerable populations","volume":"167","author":"Losina","year":"2007","journal-title":"Arch Intern Med."},{"issue":"6","key":"bib32-20230714","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1377\/hlthaff.2011.1365","article-title":"Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions","volume":"32","author":"Dimick","year":"2013","journal-title":"Health Aff (Millwood)."},{"issue":"3","key":"bib33-20230714","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/intqhc\/mzs082","article-title":"Inequality in 30-day mortality and the wait for surgery after hip fracture: the impact of the regional health care evaluation program in Lazio (Italy)","volume":"25","author":"Colais","year":"2013","journal-title":"Int J Qual Health Care."},{"key":"bib34-20230714","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1186\/1472-6963-13-393","article-title":"The impact of a pay-for-performance system on timing to hip fracture surgery: experience from the Lazio Region (Italy)","volume":"13","author":"Colais","year":"2013","journal-title":"BMC Health Serv Res."},{"issue":"14","key":"bib35-20230714","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.2106\/JBJS.I.01132","article-title":"An economic evaluation of a systems-based strategy to expedite surgical treatment of hip fractures","volume":"93","author":"Dy","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib36-20230714","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1097\/BOT.0b013e3182a5a045","article-title":"Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis","volume":"28","author":"Grigoryan","year":"2014","journal-title":"J Orthop Trauma."},{"issue":"6","key":"bib37-20230714","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/j.1532-5415.1998.tb03810.x","article-title":"Accuracy of medical records in hip fracture","volume":"46","author":"Fox","year":"1998","journal-title":"J Am Geriatr Soc."},{"issue":"1","key":"bib38-20230714","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s11999-012-2352-1","article-title":"Is administratively coded comorbidity and complication data in total joint arthroplasty valid?","volume":"471","author":"Bozic","year":"2013","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib39-20230714","doi-asserted-by":"crossref","first-page":"703","DOI":"10.2105\/AJPH.82.5.703","article-title":"Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology","volume":"82","author":"Krieger","year":"1992","journal-title":"Am J Public Health."},{"issue":"10","key":"bib40-20230714","first-page":"2159","article-title":"The influence of income and race on total knee arthroplasty in the United States","volume":"88","author":"Skinner","year":"2006","journal-title":"J Bone Joint Surg Am."},{"key":"bib41-20230714","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1186\/1472-6963-7-155","article-title":"Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals","volume":"7","author":"Cram","year":"2007","journal-title":"BMC Health Serv Res."},{"issue":"24","key":"bib42-20230714","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1056\/NEJMoa012604","article-title":"An analysis of outcomes of reconstruction or amputation after leg-threatening injuries","volume":"347","author":"Bosse","year":"2002","journal-title":"N Engl J Med."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201605180-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:26:52Z","timestamp":1787750812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201605180-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,18]]},"references-count":39,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.15.00676","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,18]]}}}