Racial and Ethnic Disparities in Providing Guideline-Concordant Care After Hip Fracture Surgery
Authors' conclusion
Older adults who received care at an institution with an SHFP were more likely to receive guideline-concordant care (bone-protective medication, WBAT-POD1, and VTE prophylaxis), regardless of race and ethnicity. However, the probability of receiving guideline-concordant care at an institution with an SHFP increased more for non-Hispanic White patients than racial and ethnic minority patients.
Study context
- Population
- Patients aged ≥65 years with hip fractures undergoing surgical fixation, American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Targeted Hip Fracture (THF) database, 2016–2021mean age 82.4 years
- Participants
- 62,194 patients
- Exposure
- Care at institutions with vs without an SHFP, in racial and ethnic minority vs non-Hispanic White patients
- Outcome
- Weight-bearing as tolerated (WBAT) on POD1, venous thromboembolism (VTE) prophylaxis, bone-protective medication, and presence of SHFP at the institution
Methodological detailsACS-NSQIP THF database 2016–2021, risk difference stratified by institution SHFP status, modified Poisson regression for interactions, multiple imputation
- ACS-NSQIP THF database 2016–2021
- Risk difference stratified by institution SHFP status
- Modified Poisson regression for interactions
- Multiple imputation
Main finding
As reported in the abstract
Guideline-concordant care, risk difference SHFP vs no SHFP, by race and ethnicity
Estimate (95% CI)
Racial and ethnic minorityvs Non-Hispanic White
risk difference (SHFP), WBAT-POD1 0.030(0.004–0.056)
Non-Hispanic White
risk difference (SHFP), WBAT-POD1 0.037(0.029–0.45)
Racial and ethnic minorityvs Non-Hispanic White
risk difference (SHFP), VTE prophylaxis 0.066(0.040–0.093)
Non-Hispanic White
risk difference (SHFP), VTE prophylaxis 0.080(0.071–0.089)
Racial and ethnic minorityvs Non-Hispanic White
risk difference (SHFP), bone-protective medication 0.149(0.121–0.178)
Non-Hispanic White
risk difference (SHFP), bone-protective medication 0.181(0.173–0.190)
Observational data: associations, not effects.
Original publication
Racial and Ethnic Disparities in Providing Guideline-Concordant Care After Hip Fracture Surgery. JAMA Netw Open. Published 1 August 2024. doi:10.
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