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Understanding delays to parathyroidectomy: A mixed-methods approach.

Catherine Chen1, Winnie Li1, Kavya K Sanghavi2

  • 1Georgetown University School of Medicine, Washington, DC.

Surgery
|July 24, 2024
PubMed
Summary
This summary is machine-generated.

Patients from minority groups experience longer delays for parathyroidectomy due to social vulnerability and other factors. Addressing these barriers is crucial for timely surgical care.

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Area of Science:

  • Endocrinology
  • Health Services Research
  • Health Equity

Background:

  • Patients from ethnic and racial minority groups with primary hyperparathyroidism may face significant delays in receiving curative parathyroidectomy.
  • The underlying reasons contributing to these disparities in care are not fully understood.

Purpose of the Study:

  • To investigate the factors contributing to time delays in parathyroidectomy for patients with primary hyperparathyroidism, with a focus on ethnic and racial disparities.
  • To identify associations between social vulnerability, patient demographics, and clinical time intervals in the pathway to parathyroidectomy.

Main Methods:

  • A sequential mixed-methods study combining quantitative retrospective chart review (2015-2020) and qualitative semistructured interviews with endocrinologists.
  • Quantitative analysis included 1,083 patients, assessing demographic data, Social Vulnerability Index (SVI) of residential areas, and clinical time intervals.
  • Qualitative analysis involved inductive thematic analysis of interviews to explore perceived reasons for care delays.

Main Results:

  • Patients from minority racial/ethnic groups were more likely to reside in socially vulnerable areas and experienced longer delays between diagnosis and parathyroidectomy compared to non-Hispanic White patients.
  • Multivariable analysis identified advanced age and residing in highly socially vulnerable areas as significant predictors of extended time intervals to parathyroidectomy.
  • Qualitative findings revealed that care delays are attributed to a complex interplay of socioeconomic, patient-related nonsocioeconomic, and non-patient-related nonsocioeconomic factors.

Conclusions:

  • Care delays in primary hyperparathyroidism treatment are multifactorial, influenced by both socioeconomic determinants and other patient- and system-related factors.
  • Addressing social vulnerability and other identified barriers is essential to reduce disparities and improve timely access to curative parathyroidectomy for all patients.