Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 23;6(3):333-337.
doi: 10.1016/j.jhsg.2024.01.011. eCollection 2024 May.

The Effect of Social Deprivation on Hospital Utilization Following Distal Radius Fracture Treatment

Matthew E Van Boxtel  1 , Isaias Jauregui  1 , Andrew Valiquette  1 , Connor Sullivan  1 , Alexander Graf  1 , Jessica Hanley  1
Affiliations

The Effect of Social Deprivation on Hospital Utilization Following Distal Radius Fracture Treatment

Matthew E Van Boxtel et al. J Hand Surg Glob Online. .

Abstract

Purpose: Social determinants of health disparities have been shown to adversely impact outcomes following distal radius fracture (DRF) treatment. Identifying risk factors for increased hospital use following DRF has been historically difficult; however, it is of utmost concern to orthopedic surgeons to improve outcomes and decrease the total cost of care. The effect of social deprivation following DRF has yet to be fully investigated.

Methods: This is a retrospective cohort analysis of a single institution's experience in treating DRF with either an operative or nonsurgical modality between 2005 and 2020. Patient demographic information and health care utilization (hospital readmission, emergency department [ED] visitation, office visits, and telephone use) were collected from within 90 days of treatment. Area Deprivation Index (ADI) national percentiles were recorded. Patients were stratified into terciles based on their relative level of deprivation, and their outcomes were compared. Secondary analyses included stratifying patients based on treatment modality, race, and legal sex.

Results: In total, 2,149 patients were included. The least, intermediate, and most deprived groups consisted of 552, 1,067, and 530 patients, respectively. Risk factors for hospital readmission included higher levels of relative deprivation. Identifying as Black or African American and nonsurgical management were risk factors for increased ED visitation. No differences in rate of hospital readmission, ED visitation, office visitation, or telephone use were seen based on deprivation level.

Conclusions: High levels of social deprivation, treatment modality, race, and legal sex disparities may influence the amount of hospital resource utilization following DRF treatment. Understanding and identifying risk factors for greater resource utilization can help to mitigate inappropriate use and decrease health care costs. We hope to use these findings to guide clinical decision making, educate patient populations, and optimize outcomes following DRF treatment.

Type of study/level of evidence: Therapeutic III.

Keywords: Deprivation; Distal radius fracture; Health disparities; Hospital readmission; Social determinants of health.

PubMed Disclaimer

Conflict of interest statement

No benefits in any form have been received or will be received related directly to this article.

Similar articles

See all similar articles

Cited by

References

    1. Clement N.D., Duckworth A.D., Wickramasinghe N.R., Court-Brown C.M., McQueen M.M. Does socioeconomic status influence the epidemiology and outcome of distal radial fractures in adults? Eur J Orthop Surg Traumatol. 2017;27(8):1075–1082. - PubMed
    1. Zeidan M., Stephens A.R., Zhang C., Presson A.P., Kazmers N.H. Evaluating the impact of social deprivation on mid-term outcomes following distal radius open reduction internal fixation. J Hand Surg Glob Online. 2021;3(5):235–239. doi: 10.1016/j.jhsg.2021.06.002. - DOI - PMC - PubMed
    1. Edwards H.B., Smith M., Herrett E., MacGregor A., Blom A., Ben-Shlomo Y. The effect of age, sex, area deprivation, and living arrangements on total knee replacement outcomes: a study involving the United Kingdom national joint registry dataset. JB JS Open Access. 2018;3(2) - PMC - PubMed
    1. Shaikh H.J., Anderson D.E., Chait A.R., et al. Use of area deprivation index to predict minimal clinically important difference for patient reported outcomes measurement information system after arthroscopic rotator cuff repair. Am J Sports Med. 2023;51(11):2815–2823. - PubMed
    1. Wright M.A., Adelani M., Dy C., O'Keefe R., Calfee R.P. What is the impact of social deprivation on physical and mental health in orthopaedic patients? Clin Orthop Relat Res. 2019;477(8):1825–1835. - PMC - PubMed