在贫困人口中优化部和膝盖关节整形:从质量改进倡议中吸取的教训
Mouhanad M El-Othmani1, Kyle McCormick2, Winnie Xu2
1Department of Orthopaedic Surgery, Brown University, Providence, RI, USA.
Arthroplasty today
|July 10, 2024
概括
在医疗补助诊所进行整体关节整形手术 (TJA) 的术前优化方案并没有减少服务不足患者群体的术后并发症. 需要进一步的研究来改善这些患者的治疗结果和健康公平.
科学领域:
- 整形外科手术 整形外科手术
- 健康 公平 卫生 公平
- 提高质量 提高质量
背景情况:
- 代表性不足的少数群体和非商业保险患者在全关节整形术 (TJA) 后面临更高的并发症率.
- 一家医疗补助诊所实施了手术前优化协议,以解决TJA结果的差异.
- 这项研究评估了该方案的有效性,并确定了管理这一患者群体的挑战.
研究的目的:
- 在医疗补助诊所评估TJA手术前优化协议的有效性.
- 确定关怀服务不足的TJA患者群体的挑战.
- 评估该协议对术后并发症的影响.
主要方法:
- 在2015年1月至2020年1月期间接受TJA的117名患者的回顾性分析.
- 医疗补助诊所的患者与私人办公室对照组之间的比较.
- 人口统计数据的收集,美国麻醉学会的得分,以及术后并发症.
主要成果:
- 与办公室组相比,医疗补助诊所患者更有可能是西班牙裔和西班牙语人士 (P=.0001).
- 临床患者经历的术后并发症明显多于办公室患者 (20对7).
- 优化方案在临床组内没有显著改变并发症或重新手术率.
结论:
- 该研究突出了服务不足的TJA人口的人口统计和并发病概况.
- 实施的质量改善计划未能改善术后结果.
- 进一步的研究是必不可少的,以提高结果,并促进健康公平这一人口.
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