医院安全网负担状况对HPV阳性口腔癌患者的影响
Shivee Gilja1, Arvind Kumar1, Danielle Kapustin1
1Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sina, New York, New York, USA.
在高安全网负担医院治疗的HPV阳性口腔状细胞癌 (OPSCC) 患者接受了更多的辐射和较少的横腔机器人手术,生存率更差. 这些发现揭示了癌症护理方面的差异.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 口腔状细胞癌 (OPSCC) 与HPV感染密切相关.
- 医院安全网负担各不相同,可能会影响患者的护理和结果.
- 了解基于医院类型的HPV阳性OPSCC的治疗差异至关重要.
研究的目的:
- 为了比较HPV阳性OPSCC患者的治疗特征和结果,在不同安全网负担的医院之间进行.
- 识别与设施安全网状态相关的护理方面的潜在差异.
主要方法:
- 对19,810名HPV阳性OPSCC患者 (cT1-4,N0-3,M0) 的回顾性分析.
- 根据医院安全网负担分组的患者:低 (LBH),中等 (MBH) 和高 (HBH).
- 多变量回归分析了初级治疗 (手术与辐射),手术方法 (TORS与开放) 和整体存活率.
主要成果:
- 与负担较低的医院 (LBH) 相比,高安全网负担医院 (HBH) 更频繁地使用辐射而不是手术 (OR:1.26).
- 与LBH患者相比,HBH患者接受过口腔机器人手术 (TORS) 的次数较少 (OR:0.30).
- 与LBH相比,接受HBH治疗的患者的整体存活率更差 (HR:1.27).
结论:
- 更高的安全网负担设施与HPV阳性OPSCC的不太理想的治疗模式有关.
- 根据医院安全网状态,在护理方面存在差异,包括手术方法和生存率.
- 调查结果强调需要解决癌症治疗的系统性不平等问题.
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