Health Inequalities in orthopaedics - size of inequalities between PROMs
Approval date: October 2020
Starting date: Ocotber 19th 2021
Amendment date: December 7th 2023
J Verhaar, J Bonsel, M Reijman, G Bonsel
Research proposal abstract
Health Inequalities (HIs) are avoidable, undesirable yet unintentional differences in people’s health, between countries or between specific populations. They are also known to exist in specific diseased populations, often understudied. The underlying mechanisms are manifold, but once these HIs are recognized, and analysed - with the care sector for the part depending on care processes - they are amenable for reduction. While socio-economic HIs (income, education related) are best known, HIs also exist according to ethnicity, living place (large cities/rural areas), and health literacy. In this study HIs are analysed in primary hip and knee arthroplasty for osteoarthritis patients. General and socio-demographic characteristics are retrieved from the Dutch Orthopedic Registry (LROI). With a linkage procedure and a
public source file developed by the Sociaal Cultureel Planbureau, each individual postal code will be transformed into a socio-economic status score. This technique has been validated, and has been applied in numerous HI studies. HIs will be primarily assessed on the generic quality of life measures (EQ-5D and EQ-VAS), but analyses will be repeated for disease-specific questionnaires. Recent standards by the
EuroQol group (specifically Health Inequalities Special Interest Group) will be used. In the last phase of the project clinicians will be asked to comment on the analyses to unravel pathways to HIs and to identify potential preventive options to diminish HIs.