在一次性甲状腺功能障碍症中进行手术转诊的门:联合分析
Christopher Wu1, Andrea Gillis1, Mohamad Sidani2
1Department of Surgery, Division of Breast and Endocrine Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
American journal of surgery
|July 26, 2023
概括
原发性副甲状腺症 (PHPT) 的手术转诊取决于患者的年龄和骨质疏松症等因素,而不是医生的特点. 需要改善教育,以增加PHPT患者的手术接入.
科学领域:
- 内分泌学 在内分泌学.
- 手术推模式 手术推模式
- 医疗保健服务研究 医疗服务研究
背景情况:
- 初级偏甲状腺症 (PHPT) 可以通过手术治愈,但患者转诊模式不一致.
- 转介决策通常受到个人医疗保健提供者的影响.
- 了解这些影响是改善PHPT手术准入的关键.
研究的目的:
- 确定影响PHPT外科治疗医生转诊的关键因素.
- 分析临床和生化参数对外科推决定的影响.
主要方法:
- 通过在线调查进行了一项联合分析研究.
- 医生 (内分泌学家和其他人) 评估了10个患者的情况.
- 转诊决定是基于临床 (年龄,并发症) 和生化 (轻度与经典PHPT) 因素.
主要成果:
- 对于经典的PHPT,50岁以下的患者,没有并发症的患者和患有骨质疏松症 (p < 0.001) 的患者,进行手术的转诊显著更高.
- 看到一个外科提供者也增加了转诊的可能性.
- 医生人口统计学 (性别,经验,环境) 并没有显著影响转诊决定.
结论:
- 非手术医生不太可能转介老年患者 (年龄≥50岁),患有并发症或轻度疾病的患者进行手术.
- 尽管已经证实了外科手术的好处,但由于医疗服务提供商的因素,接入仍然有限.
- 增加医生教育和宣传对于提高PHPT的外科治疗机会至关重要.
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