改变慢性阻塞性肺病退伍军人肺功能测试的种族特异方程的影响
Laura J Spece1,2,3, Travis Hee Wai1,2, Lucas M Donovan1,2,3
1Center of Innovation for Veteran-Centered and Value-Driven Care.
Annals of the American Thoracic Society
|May 31, 2024
概括
改变螺旋计参考方程可能会影响退伍军人获得肺部疾病治疗和残疾福利,并观察到种族差异. 重新评估临床门对于以患者为中心的护理至关重要.
科学领域:
- 肺部医学 肺部医学
- 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:
- 美国胸腔学会建议使用单一的螺旋计参考方程,但其对患者护理的实际影响尚不清楚.
- 慢性阻塞性肺病 (COPD) 管理依赖于精确的螺旋计,以评估治疗资格和残疾.
研究的目的:
- 估计采用单一的螺旋计参考方程对COPD退伍军人的影响.
- 分析获得肺癌手术,肺体积减小手术 (LVRS) 和肺移植转诊的潜在变化.
- 根据种族和种族来评估对残疾福利的财务影响.
主要方法:
- 一项横截面研究分析了2010-2019年间44892名患有COPD的退伍军人 (40-89岁) 的螺旋计数据.
- 从21个设施收集了种族,种族和电子健康记录数据.
- 肺功能达到临床值的计算百分比变化以及不同种族/族群和美国退伍军人事务部服务连接水平的财务影响.
主要成果:
- 采用单一方程降低了亚裔和黑人退伍军人的预测肺功能,可能降低了肺切除资格,但增加了黑人退伍军人的LVRS和移植转诊资格.
- 白人退伍军人显示预测肺功能增加,可能增加肺切除资格,但减少LVRS和移植转诊资格.
- 在潜在的每月残疾支付变化中,种族差异是显而易见的:一些亚裔和黑人退伍军人的增加,白人退伍军人的减少.
结论:
- 一个单一的螺旋计参考方程可以不成比例地影响退伍军人基于种族获得医疗治疗和残疾福利的机会.
- 该研究强调,如果采用新的参考方程,需要重新评估临床值和以患者为中心的结果.
- 确保公平获得护理和福利需要仔细考虑螺旋计参考方程变化对不同退伍军人群体的影响.
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