根据保险,关节骨关节炎的治疗时间和类型是否有变化?
Aritra Chakraborty1, Thompson Zhuang1, Lauren M Shapiro2
1Department of Orthopaedic Surgery, VOICES Health Policy Research Center, Stanford University School of Medicine, Redwood City, California.
与医疗保险优势或商业保险患者相比,Medicaid患者面临更长的等待时间和更低的关节整形手术 (THA) 费率. 这突显了关节骨关节炎护理获得的显著差异.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 保险类型会影响获得关节整形手术 (THA) 的机会.
- 目前尚不清楚保险差异是否会影响关节骨关节炎 (OA) 的THA时间.
研究的目的:
- 为了评估THA率和手术的时间是否因部OA患者的保险类型而异.
- 将THA与基于保险覆盖的非手术干预 (NOI) 进行比较.
主要方法:
- 对关节骨关节炎患者国家索赔数据库 (2011-2019) 的分析.
- 根据保险对患者的分类:医疗补助,医疗保险优势和商业.
- 多变量后勤回归用于评估THA与保险类型的关联,并对共变量进行调整.
主要成果:
- 与医疗保险优势 (10.9%,215天) 和商业 (12.0%,261天) 组相比,医疗补助患者在3年内的THA率 (7.4%) 和更长的手术时间 (297天) 显着较低.
- 多变量分析证实,与其他保险组相比,Medicaid患者接受THA (OR 0.62-0.63) 或NOI (OR 0.81-0.92) 的可能性较低.
- P值<.0001表明THA速率和手术时间的统计学上显著差异.
结论:
- 与医疗保险优势和商业保险相比,医疗补助保险与THA的费率降低和延迟增加有关.
- 需要进一步的研究来确定和解决这些访问差异的根本原因.
- 确保对关节骨关节炎的公平护理需要调查成本和访问限制等障碍.
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