Editorial Commentary: Understanding the Gap in Clinical Outcomes After Rotator Cuff Repair Based on the Influence of Social Determinants of Health.

Abstract

There is growing recognition and understanding of the important role that social determinants of health and access to care play in surgical outcomes, particularly in the field of orthopaedic surgery and sports medicine. Factors including race, ethnicity, education, income, insurance status, social class, and sex have been identified as important contributors to outcomes after orthopaedic procedures, including rotator cuff repair. Disadvantaged or marginalized patients have been shown to attend fewer office visits and physical therapy sessions, are more likely to present with advanced stages of disease, have delayed surgical interventions, and have poorer patient-reported outcomes after surgery. Virtual visits and telemedicine have the great ability to improve access to medical professionals for disadvantaged patients who have poor access to transportation. However, reliance on telehealth has the potential to worsen access to care for patients with limited access to technology or language barriers. Disadvantaged populations, including those with noncommercial health care insurance, show decreased use of telemedicine.