Race and Rehabilitation Services After Joint Replacement

Dr. Said A. Ibrahim, Chief, Division of Healthcare Delivery Science and Innovation, Department of Healthcare Policy and Research, Weill Cornell Medicine, recently used inpatient discharge data from the Pennsylvania Health Care Cost Containment Council (PHC4) to study patients who had a total hip and/or knee replacement.

As part of a project entitled, Race and Rehabilitation Services After Joint Replacement, Dr. Ibrahim found the PHC4 dataset to be an excellent resource to examine variations in healthcare use and outcomes. In particular, he and his research team used the dataset to examine how social determinants of health, such as race/ethnicity, gender and socioeconomic status, impact utilization and outcomes of elective joint replacement.

From the data analyses, Dr. Ibrahim and his colleagues concluded that there are marked variations by race with regard to where patients go for post-operative care and rehabilitation services after elective joint replacement surgery. Additionally, they discovered that the type of post-acute care and rehabilitation services was associated with readmission rates and surgical revision rates—where patients go (home vs institution) has implications for readmission to an acute care hospital, an important health care quality marker.

The long-term objective of Dr. Ibrahim’s research is to mitigate racial disparity in access and use of elective knee and hip replacement by identifying and intervening on key factors in the clinical care pathway, one of which may be differential access to post-acute care and rehab services. Thus far, Dr. Ibrahim published a few articles on this topic in Geriatric Orthopaedic Surgery & Rehabilitation.^{1, 2}

To improve care for all patients, Dr. Ibrahim stressed the importance of PHC4’s datasets for conducting research. He stated, “The PHC4 dataset is truly a unique resource for improving healthcare not only for Pennsylvanians, but for the nation at large. The insight gained from the PHC4 dataset has the potential to inform national policy on healthcare.”

He characterized his experience of working with PHC4 and the process to obtain PHC4 data as “an exceptionally pleasant experience” and singled out, in particular, the outstanding leadership and commitment to excellence of PHC4’s special request staff.

---

¹Vina ER, Kallan MJ, Collier A, Nelson CL, Ibrahim SA. Race and rehabilitation destination after elective total hip arthroplasty: analysis of a large regional data set. Geriatr Orthop Surg Rehabil. 2017;8(4):192-201.

²Jorgenson ES, Richardson DM, Thomasson AM, Nelson CL, Ibrahim SA. Race, rehabilitation, and 30-day readmission after elective total knee arthroplasty. Geriatr Orthop Surg Rehabil. 2015;6(4):303-310.

---

Read about how other clients use PHC4 data.