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Date of Award

Spring 2023

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Kimberly Erikson, MSPAS, PA-C

Abstract

Each year over a million hip and knee arthroplasty surgeries are performed in the United States. Total joint arthroplasty is a highly cost-effective intervention and can reduce overall health care spending associated with the continued care of chronic conditions such as osteoarthritis and associated disability over time. By investing in preventative measures, the long-term savings can contribute to overall lowered cost burden on the healthcare system. Total joint arthroplasty has the potential to drastically improve the overall quality of life of patients. Patients who receive total joint arthroplasty often have restored mobility and regain the ability to enjoy a more mobile lifestyle with reduced pain. With the number of lower extremity total joint replacement surgeries being performed each year, it is increasingly important to evaluate potential barriers to access patients may face. Inflexible eligibility criteria are a barrier to total joint arthroplasty access and has several long-term consequences. Restricted access to total joint arthroplasty also has the potential to exacerbate existing racial and socioeconomic healthcare disparities. Current guidelines have not adapted to account for changes within the demographic features of the current United States population. Obesity is an epidemic in the United States and eligibility criteria for surgical candidates for total joint arthroplasty has not altered guidelines to accommodate for this increasing prevalence of obesity in the general population. It is important to acknowledge the ways in which the healthcare system may be failing to help some individuals access care and the ways in which providers who function within this system can help combat these barriers.

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Barriers to Access for Total Joint Arthroplasty: How Strict Weight-Based Eligibility Criteria May Further Exacerbate Racial and Socioeconomic Disparities in the U.S. Healthcare System

Each year over a million hip and knee arthroplasty surgeries are performed in the United States. Total joint arthroplasty is a highly cost-effective intervention and can reduce overall health care spending associated with the continued care of chronic conditions such as osteoarthritis and associated disability over time. By investing in preventative measures, the long-term savings can contribute to overall lowered cost burden on the healthcare system. Total joint arthroplasty has the potential to drastically improve the overall quality of life of patients. Patients who receive total joint arthroplasty often have restored mobility and regain the ability to enjoy a more mobile lifestyle with reduced pain. With the number of lower extremity total joint replacement surgeries being performed each year, it is increasingly important to evaluate potential barriers to access patients may face. Inflexible eligibility criteria are a barrier to total joint arthroplasty access and has several long-term consequences. Restricted access to total joint arthroplasty also has the potential to exacerbate existing racial and socioeconomic healthcare disparities. Current guidelines have not adapted to account for changes within the demographic features of the current United States population. Obesity is an epidemic in the United States and eligibility criteria for surgical candidates for total joint arthroplasty has not altered guidelines to accommodate for this increasing prevalence of obesity in the general population. It is important to acknowledge the ways in which the healthcare system may be failing to help some individuals access care and the ways in which providers who function within this system can help combat these barriers.