The Impact of Subspecialty Training and the Social Determinants of Health on Glenohumeral Joint Instability Treatment in Rhode Islandtext_resourcesGlenohumeral joint instability represents a diverse subset of orthopedic lesions. As such, even within best practice guidelines, there are a multitude of competing treatment strategies among providers. One of the largest influencing factors on treating-physician surgical approaches and non-surgical management is subspecialty fellowship and residency training. Within the field of orthopedics specifically, the large overlap on new case sub-specialty coverage may amplify differences in treatment modalities. With referrals of new cases being assigned according to protocols and availability that vary by institution, it is unclear how clinical practice patterns are altered dependent on physician training here in Rhode Island. Literature dictates that lower SES and insurance status can be tied to lower utilization, time to treatment and methodology of intervention, and studies in other disciplines, like anesthesia, have shown that these factors may be correlated with institution of referral as well. This study aims to examine the impact of specialty training on management techniques of glenohumeral joint instability in a Rhode Island Population through use of the Rhode Island All Payers Claims Database (RIAPCD) and evaluate referral patterns among the RIAPCD population to determine the impact of patient insurance type and SES on said referrals. We hope to demonstrate that residency and fellowship training significantly impact offered care management strategies, and highlight a significant difference in offered care strategies based on SES and insurance type.Pietro, JohnAuthorHe, ElaineAuthorDinh, PeterAuthorWoo, JoshuaAuthorAlbright, AlexAuthorOwens, BrettAuthorBrown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentratorresearch programOrthopedic surgeryShoulder jointEnglish2024Non-Scholarly ConcentratorAll rights reservedIn CopyrightAll Rights Reserved