Findings in Managed Care Reported from Eastern Virginia Medical School (Low Socioeconomic Indicators Correlate With Critical Preoperative Glenoid Bone Loss and Care Delays): Managed Care

2025 MAY 16 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Managed Care. According to news reporting from Norfolk, Virginia, by NewsRx journalists, research stated, “Chronic and recurrent shoulder dislocations prior to stabilization can increase the risk of glenoid bone loss. Glenoid bone loss exceeding critical levels can lead to further instability and decreased outcomes following arthroscopic labral repair.”

The news correspondents obtained a quote from the research from Eastern Virginia Medical School, “Indicators of low socioeconomic status (SES), such as high Area Deprivation Index (ADI) and noncommercial insurance, are related to generalized delays to orthopedic care, which can cause recurrent instability and increase glenoid bone loss. Higher national ADI and noncommercial insurance would be associated with greater levels of radiographic glenoid bone loss after glenoid instability. A retrospective study was performed with patients who underwent anterior labral repair. Chart review included demographics, course of care data, preoperative instability data, national ADI, and insurance status. The Neighborhood Atlas Website and patients’ home addresses were used to obtain national ADI. Glenoid bone loss was measured using the best-fit circle Pico method on three-dimensionally aligned magnetic resonance images. Researchers were blinded to SES indicators during radiographic analysis. Glenoid bone loss was compared between SES indicators using one-way analysis of variance. One hundred forty-six patients met inclusion criteria and had complete datasets (23.3% female; 22.4 +/- 7.0-year-old; national ADI = 16.1 +/- 15.3). Patients experienced on average 9.12 +/- 6.63% glenoid bone loss. A curve fitting tool determined a quadratic nonlinear regression best characterized the association of glenoid bone loss and ADI (R-2 = 0.392, P< .001). Individuals with commercial insurance experienced 8.58% +/- 6.69% glenoid bone loss as compared to 11.78% +/- 6.30% in individuals with Medicaid insurance (P = .03). Critical bone loss at a threshold of 13.5% was more likely with higher national ADI (P < .001) and Medicaid insurance (OR = 2.49, CI = 1.02-6.09). However, only national ADI was predictive of subcritical bone loss at a threshold of 10% (P < .001). Patients with greater national ADI and Medicaid insurance status had greater rates of critical preoperative glenoid bone loss at a threshold of 13.5%. Greater national ADI is also predictive of subcritical glenoid bone loss at a threshold of 10% and overall glenoid bone loss.”

According to the news reporters, the research concluded: “Further study is needed to assess the postoperative implications of these findings in this population.”

This research has been peer-reviewed.

For more information on this research see: Low Socioeconomic Indicators Correlate With Critical Preoperative Glenoid Bone Loss and Care Delays. Journal of Shoulder and Elbow Surgery, 2025;34(5):1356-1367. Journal of Shoulder and Elbow Surgery can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Journal of Shoulder and Elbow Surgery - http://www.journals.elsevier.com/journal-of-shoulder-and-elbow-surgery/)

Our news journalists report that additional information may be obtained by contacting Benjamin E. Neubauer, Eastern Virginia Medical School, Norfolk, VA, United States. Additional authors for this research include Christopher M. Kuenze, Rachel E. Cherelstein, Mitchell A. Nader, Edward S. Chang and Albert Lin.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.jse.2024.08.039. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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