脊髓刺激器在美国军事卫生系统中的不平等
Ysehak Wondwossen1, Michael S Patzkowski2, Maxwell Y Amoako3
1School of Medicine, Uniformed Services University, Bethesda, MD, USA.
概括
黑人患者接受脊髓刺激 (SCS) 的次数比白人患者少. 白人患者在SCS之前尝试较少的治疗方法,而黑人患者没有显示这种模式,表明需要公平的护理途径.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 疼痛管理 疼痛管理
背景情况:
- 研究表明,在脊髓刺激 (SCS) 获得方面存在种族不平等.
- 缺乏关于系统级变革的数据,以促进SCS的健康公平.
- 这项研究调查了种族群体在SCS之前的治疗疲劳.
研究的目的:
- 评估黑人患者在接受SCS之前是否比白人患者耗尽了更多的治疗选择.
- 确定潜在的系统层面的因素,有助于SCS差异.
主要方法:
- 美国军事卫生系统数据 (2017-2020) 的回顾性队列研究.
- 包括黑人和白人患者,患有持续性脊柱疼痛综合征 (PSPS) 后背手术.
- 一般化的线性模型分析了SCS接收预测因素,包括种族和治疗类型.
主要成果:
- 黑人患者 (10.3%) 与白人患者 (13.6%) 相比,接受SCS的可能性较低.
- 有意义的相互作用:接受0-3次治疗的白人患者比接受0-3次治疗的黑人患者更有可能患上SCS.
- 黑白患者试过>3种治疗方法时,SCS发生的可能性与黑白患者相似.
结论:
- 与黑人患者相比,PSPS的白人患者在SCS之前尝试了较少的治疗方法.
- 治疗次数与黑人患者的SCS接收没有显著的关系.
- 调查结果表明,需要有结构的推途径和以股权为中心的提供商评估.
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