abstract: 'Background: This study looked at the effect of patient demographics,

  insurance status, education, and patient opinion on whether various

  orthotic footwear prescribed for a variety of diagnoses were received by

  the patient. The study also assessed the effect of the orthoses on

  relief of symptoms. Methods: Chart review documented patient

  demographics, diagnoses, and medical comorbidities. Eligible patients

  completed a survey either while in the clinic or by phone after their

  clinic visit. Results: Of the 382 patients prescribed orthoses, 235

  (61.5\%) received their orthoses; 186 (48.7\%) filled out the survey.

  Race and whether or not the patient received the orthosis were found to

  be significant predictors of survey completion. Race, type of insurance,

  and amount of orthotic cost covered by insurance were significant

  predictors of whether or not patients received their prescribed

  orthoses. Type of orthosis, diabetes as a comorbidity, education,

  income, sex, and diagnosis were not significant predictors of whether

  the patient received the orthosis. Qualitative results from the survey

  revealed that among those receiving their orthoses, 87\% experienced

  improvement in symptoms: 21\% felt completely relieved, 66\% felt

  better, 10\% felt no different, and 3\% felt worse. Conclusion: We found

  that white patients had almost 3 times the odds of receiving prescribed

  orthoses as black patients, even after controlling for type of

  insurance, suggesting race to be the primary driver of discrepancies,

  raising the question of what can be done to address these inequalities.

  While large, systematic change will be necessary, some strategies can be

  employed by those working directly in patient care, such as informing

  primary care practices of their ability to see patients with limited

  insurance, limiting blanket refusal policies for government insurance,

  and educating office staff on how to efficiently work with Medicare and

  Medicaid.'
affiliation: 'Bettin, CC (Corresponding Author), Univ Tennessee, Dept Orthopaed Surg
  \& Biomed Engn, Campbell Clin, 1211 Union Ave,Suite 510, Memphis, TN 38104 USA.

  Stevens, Trenton T.; Grear, Benjamin J.; Richardson, David R.; Murphy, G. Andrew;
  Bettin, Clayton C., Univ Tennessee, Dept Orthopaed Surg \& Biomed Engn, Campbell
  Clin, 1211 Union Ave,Suite 510, Memphis, TN 38104 USA.

  Hartline, Jacob T., Univ Maryland Med Syst, Baltimore, MD USA.

  Ojo, Oluwatosin, OrthoGeorgia, Macon, GA USA.'
author: Stevens, Trenton T. and Hartline, Jacob T. and Ojo, Oluwatosin and Grear,
  Benjamin J. and Richardson, David R. and Murphy, G. Andrew and Bettin, Clayton C.
author-email: cbettin@campbellclinic.com
author_list:
- family: Stevens
  given: Trenton T.
- family: Hartline
  given: Jacob T.
- family: Ojo
  given: Oluwatosin
- family: Grear
  given: Benjamin J.
- family: Richardson
  given: David R.
- family: Murphy
  given: G. Andrew
- family: Bettin
  given: Clayton C.
da: '2023-09-28'
doi: 10.1177/1071100721990343
eissn: 1944-7876
files: []
issn: 1071-1007
journal: FOOT \& ANKLE INTERNATIONAL
keywords: insurance status; race; inequality
keywords-plus: 'RACIAL/ETHNIC DISPARITIES; KNEE ARTHROPLASTY; HEALTH-INSURANCE;

  REPLACEMENT; MANAGEMENT; ADHERENCE; INCOME; HIP'
language: English
month: JUL
number: '7'
number-of-cited-references: '33'
pages: 894-901
papis_id: a2180380ab262b58d06acb9c89c4aa7f
ref: Stevens2021raceinsurance
times-cited: '1'
title: Race and Insurance Status Association With Receiving Orthopedic Surgeon-Prescribed
  Foot Orthoses
type: article
unique-id: WOS:000674962400010
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '42'
web-of-science-categories: Orthopedics
year: '2021'