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Rural Residents More Likely to Have Total Joint Replacement

Last Updated: December 02, 2009.

Medicare beneficiaries living in rural areas may be more likely to have total knee or hip replacement surgery than urban beneficiaries, contrary to factors that would suggest the opposite relationship, according to research published in the December issue of Arthritis & Rheumatism.

WEDNESDAY, Dec. 2 (HealthDay News) -- Medicare beneficiaries living in rural areas may be more likely to have total knee or hip replacement surgery than urban beneficiaries, contrary to factors that would suggest the opposite relationship, according to research published in the December issue of Arthritis & Rheumatism.

Mark L. Francis, M.D., of the Southern Illinois University School of Medicine in Springfield, and colleagues analyzed Medicare data from 2005 on elective total knee and hip replacements, thus excluding patients with fractures, cancers, and revisions. The authors used a system with a one to 10 scale to define rural versus urban settings.

The researchers found that rural beneficiaries were 27 percent more likely to have a joint replacement surgery than urban beneficiaries. Even after adjustment for age, race, household income and other relevant factors, rural individuals still had a 14-percent higher likelihood of the procedures. Another database with individuals aged 50 to 64 years showed that younger rural patients were also more likely to have these surgeries, indicating that patients weren't waiting until Medicare eligibility for joint replacement.

"This willingness of rural individuals to undergo elective surgical procedures has important implications when coupled with the findings of studies that demonstrate improved surgical outcomes for a given procedure in centers that perform a high volume of that surgery," the authors write. "These results suggest there is no need to increase the availability of elective surgical procedures, such as total joint replacement surgeries, within rural environments."

A co-author reported financial relationships with several research and consulting companies.

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