对脊柱疾病的诊断成像和非药物保守治疗的使用的社会经济差异
Falko Tesch1, Jochen Schmitt2, Patrik Dröge3
1Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany. falko.tesch@ukdd.de.
BMC musculoskeletal disorders
|October 2, 2023
概括
脊椎病患者在获得医疗保健方面表现出社会经济差异. 更高的社会经济地位与诊断成像和治疗的使用增加有关,特别是昂贵的像MRI和手动治疗.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
- 脊柱疾病管理管理
背景情况:
- 基于社会经济地位 (SES) 的医疗保健利用差异挑战了公平待遇原则.
- 研究了基于SES的诊断成像和脊髓疾病的非药物保守疗法的差异.
研究的目的:
- 确定脊柱疾病的医疗保健利用中的社会经济差异的存在和程度.
- 分析基于SES的诊断成像和保守疗法的使用差异.
主要方法:
- 德国的一项大型队列研究 (2012-2016年1170万患者年) 针对脊髓疾病患者 (ICD-10:M40-M54).
- 波松回归模型用于评估SES (教育,职业) 对诊断成像 (放射学,CT,MRI) 和保守治疗 (物理治疗,手术治疗,针) 的利用的影响.
主要成果:
- 在26%的患者年中使用诊断成像;在32%的患者年中使用物理治疗;在25%的患者年中使用脊柱操纵疗法;在4%的患者年中使用针.
- 较高的SES与诊断成像和治疗的利用率增加相关,反映了之前的发现.
- 对手动治疗,运动治疗和磁共振成像 (MRI) 的差异最为显著.
结论:
- 在脊髓疾病的医疗保健利用方面存在显著的社会经济差异.
- 更昂贵的医疗保健服务,如MRI和专业疗法,与SES相关的差异更大.
- 需要进一步的研究来解决公平获取障碍,并减少医疗保健中的社会差异.
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