超越种族:社会脆弱性和获得代谢和减肥手术的机会
Kayla A Councell1, Ava Ferguson Bryan1, Ann M Polcari1
1Department of Surgery, University of Chicago, Chicago, IL.
概括
社会脆弱的患者面临着代谢和减肥手术 (MBS) 的重大障碍,包括增加的医疗体重管理 (MWM) 要求,导致更高的消耗率和不同的护理.
科学领域:
- 肥胖医学 肥胖医学
- 手术健康差异的差异
- 医疗保健服务研究 医疗服务研究
背景情况:
- 代谢和减肥手术 (MBS) 在非白人人口中未得到充分利用,这些人患肥胖率不成比例.
- 社会脆弱患者面临的独特障碍可能会导致MBS获得的差异.
研究的目的:
- 调查在MBS之前,社会脆弱的患者是否会遇到更高的消耗率和更严格的保险规定的医疗体重管理 (MWM) 要求.
- 分析社会脆弱性与MBS接入之间的关联.
主要方法:
- 2018年在一个城市学术中心对MBS进行评估的成年患者的回顾性队列研究.
- 使用2018年社会脆弱性指数评估的社会脆弱性.
- 结果包括手术磨损和MWM要求 (数量和持续时间);进行了多变量回归分析.
主要成果:
- 该研究包括339名患者 (70%黑人,83%女性);57%的患者经历了磨损.
- 与最不易受伤害的患者相比,处于社会最脆弱的四分之一患者的消耗率 (OR 2.33) 翻了一番.
- 高度脆弱的患者面临MWM要求的两倍和近四倍的持续时间,独立预测消耗.
结论:
- 较高的社会脆弱性与减少MBS利用和增加手术前MWM任务有关.
- 保险规定的MWM要求似乎不公平,可能会加剧严重肥胖患者的护理差异.
- 解决社会脆弱性和MWM要求对于公平的MBS准入至关重要.
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