It was found that in the patient population, with mostly low opportunity scores by the COI metric and mostly public insurance, there was no difference in timing to diagnosis of hip dysplasia. These unexpected results provide reassurance that departments and institutions that care for a diverse population despite socioeconomic factors, can provide care for an important pediatric condition.

Hip dysplasia is the most common orthopedic problem affecting newborns. Timely diagnosis is a critical factor in the success of non-operative treatment in the first few months of life. As a large leading academic institution serving a diverse population, Montefiore Einstein was exceptionally positioned to study the timing of DDH diagnosis in a population with predominantly low or very low COI scores and public insurance. The retrospective study looked at patients younger than 4 years diagnosed with DDH between 2016 and 2023, examining recorded clinical and demographic data, including that of first diagnostic imaging.

One might expect social determinants of health to delay a diagnosis and treatment of conditions that necessitate imaging and evaluation by a surgical subspecialist in the first few weeks of life. However, the results showed no significant difference between early and late diagnosis subgroups by COI and no significant difference between median age at the time of first diagnostic imaging between the lower and higher COI score subgroups.

As noted, this is the first study to pose this question on DDH in a population with predominantly low or very low COI scores and public insurance, which may lead to unexpected results. Replicating the study in a different setting could yield different results.