在执业的耳鼻喉科医生中,患者共患病概况有多变化?
Sina J Torabi1, Ellen M Hong1, Rahul A Patel2
1Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California, USA.
概括
耳鼻喉科医生 (ORLs) 在城市,学术环境中,并在职业生涯的早期治疗更多伴随疾病的患者. 患者复杂性的这种变化可能会影响实践成本和结果,可能导致健康不平等.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 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:
- 医生实践模式可以影响患者的结果和医疗保健成本.
- 了解耳鼻喉科医生 (ORL) 之间的并发症分布对于资源分配和公平护理至关重要.
- 阶层状况类别 (HCC) 风险评分作为患者并发症负担的验证度量.
研究的目的:
- 调查耳鼻喉科医生 (ORL) 中患者共患病概况的变异.
- 确定与治疗具有较高并发症负担的患者相关的医生特征.
- 探索耳鼻喉科实践对健康公平的潜在影响.
主要方法:
- 基于人口的横截面分析,使用2019年医疗保险提供者利用和支付数据集.
- 每个ORL治疗的Medicare患者的计算平均HCC风险得分.
- 根据医生特征分层和比较HCC分数:实践地区,农村地区,实践年数,性别,子专业和实践环境 (学术与社区).
主要成果:
- 在8959个ORL中,HCC风险平均得分为1.35±0.35.
- 在城市环境,学术实践和职业生涯早期的ORL具有显著更高的患者HCC风险得分 (P < .001).
- 多变量分析证实,农村实践环境 (OR:0.58) 和社区环境 (OR:0.36) 与高风险患者的几率较低有关,而最近的毕业 (2000-2015) 与增加的几率有关.
结论:
- 在耳鼻喉科医生中,患者的并发症概况存在显著的变异性.
- 城市,学术环境中的医生以及最近毕业的医生管理患者的并发症负担较高.
- 这些实践变化对医疗保健成本,临床结果和耳鼻喉科内的健康公平有潜在的影响.
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