在右下象限疼痛的儿童中,成像利用的社会人口学预测因素
Michael P George1,2, Patrice Melvin3, Amanda W Grice3
1Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. michael.george@childrens.harvard.edu.
Pediatric radiology
|November 6, 2024
概括
社区机会,种族和保险状况等社会人口统计因素预测右下象限疼痛儿童的诊断成像. 观察到成像利用的差异,突出了儿科医疗保健中的不平等.
科学领域:
- 儿科卫生服务研究 儿童卫生服务研究
- 卫生公平研究 卫生公平研究
- 诊断成像利用的使用方法
背景情况:
- 获得医疗保健的不平等与儿童的结果差异相关.
- 儿童急性尾炎诊断成像的社会人口学预测因素仍然被低估.
- 以前的研究表明,儿童尾炎的健康结果可能存在差异.
研究的目的:
- 评估影响诊断成像的社会人口学因素,对儿童呈现右下象限 (RLQ) 疼痛.
- 根据社会人口统计学变量,测试成像利用差异存在的假设.
- 在儿科RLQ疼痛评估中确定成像模式选择的特定预测因素.
主要方法:
- 全国范围的回顾性队列研究使用儿科健康信息系统 (PHIS) 数据库 (2018-2023).
- 包括儿童 (0-18岁) 患有RLQ疼痛的急诊室遭遇 (ICD代码CM R10.31).
- 分析了社区社会人口统计 (儿童机会指数),种族/种族和保险状况作为主要暴露,控制共变量.
主要成果:
- 较低的儿童机会指数,黑人种族/种族和公共保险与没有成像或X光片单独相关.
- 更高的儿童机会指数和商业保险预测了超声波 (美国) 的使用.
- 种族/种族和医院地区显著影响了计算机断层扫描 (CT) 和磁共振成像 (MRI) 的利用.
- 患者的孩子机会指数没有预测CT或MRI在三级中心的可能性.
结论:
- 在儿科RLQ疼痛的诊断成像中显著的社会人口学差异在三级护理环境中是明显的.
- 包括邻里机会,种族/种族,保险和医院地区在内的因素有助于这些不平等.
- 进一步的研究是有必要的,以调查这些差异在医院和部门层面的根本原因.
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