TABLE II.

Mean HRR-Level Age and Sex-Standardized Hip and Knee Replacement Rates in 2017 by Quartiles of the Percentage of Black or Dual-Eligible Medicare Beneficiaries^*

	By Quartiles of Black Beneficiaries				By Quartiles of Dual-Eligible Beneficiaries
	Hip Replacement		Knee Replacement		Hip Replacement		Knee Replacement
	Adjusted Rate†	Difference	Adjusted Rate†	Difference	Adjusted Rate†	Difference	Adjusted Rate†	Difference
Quartile 1	4.71	—	9.59	—	4.90	—	10.02	—
Quartile 2	4.69	−0.42%	9.66	0.73%	4.72	−3.67%‡	9.78	−2.40%
Quartile 3	4.56	−3.18%	9.33	−2.71%	4.54	−7.35%§	9.31	−7.09%§
Quartile 4	4.41	−6.37%‡	9.00	−6.15%‡	4.21	−14.08%§	8.46	−15.57%§

^*The table presents the 2017 adjusted estimates of hip and knee utilization rates by quartiles of the percentage of black or dual-eligible Medicare beneficiaries in the HRR. The estimates were derived from multilevel mixed-effects linear regression models with HRR-level random effects and an exchangeable covariance structure that used data from 2009 to 2017 (Appendix Exhibit S11).

^†The values are given as the rate per 1,000 surgical procedures.

^‡Significant at p < 0.05.

^§Significant at p < 0.001.