在社区层面的社会脆弱性和部和膝关节关节置换手术收据在医疗保险注册的关节炎患者中
Sarah H Yi1, Renee M Calanan2,3, Michael J A Reid4,5
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Medical care
|October 7, 2024
概括
社会脆弱性与较低的关节整体置换 (TJR) 率有关,差异因种族/种族而异. 解决这些社会决定因素是改善公平获得TJR程序的关键.
科学领域:
- 公共卫生 公共卫生
- 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:
- 健康的社会决定因素对医疗保健的获取有很大影响,特别是对于像全关节置换 (TJR) 这样的手术.
- 了解社会脆弱性的细微差别对于制定有效的政策来促进公平的TJR获取至关重要.
研究的目的:
- 调查县级少数群体健康社会脆弱性指数 (MH-SVI) 与整体关节置换 (TJR) 率之间的关联.
- 为了检查这些协会是如何根据个人种族/种族而有所不同.
主要方法:
- 使用医疗保险索赔数据 (n=10,471,413) 的回顾性队列研究,用于2018年67岁以上的关节炎患者.
- 将医疗保险数据与MH-SVI联系起来,以根据县脆弱性四分位数评估TJR赔率.
- 使用多变量后勤回归,按种族/种族分层结果.
主要成果:
- 种族和民族少数群体 (亚裔美国人,夏威夷原住民或太平洋岛民;黑人;西班牙裔) 与白人入学者相比,接受TJR的几率降低了26%-41%.
- 居住县的复合和社会经济脆弱性更高与所有群体中较低的TJR率相关.
- 特定的脆弱性主题 (医疗,住房,交通,少数群体地位,语言,家庭组成) 显示了根据种族/种族与TJR的不同关联.
结论:
- 较高的社会脆弱性与TJR利用率的减少有关,在种族和种族群体之间存在显著差异.
- 量身定制的多部门战略对于减轻差异和确保所有人均平等获得TJR至关重要.
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