谁得到了推?谁得到了推? 在获得超副甲状腺症专家护理方面的差异
John P O'Connor1, Rebecca Sippel2, Courtney Balentine2
1University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
The Journal of surgical research
|July 2, 2025
概括
社会决定因素影响了原发性甲状腺功能障碍症 (PHPT) 的诊断. 专家推的差异,而不是初步测试,阻碍了治疗机会,特别是对弱势群体.
科学领域:
- 内分泌学 在内分泌学.
- 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:
- 原发性偏甲状腺症 (PHPT) 导致显著的发病率,包括骨折和心血管事件.
- 甲状腺切除术未得到充分利用,尤其是在弱势群体中.
- 健康的社会决定因素可能会影响PHPT诊断和治疗途径.
研究的目的:
- 研究邻里优势与PHPT的诊断和治疗途径之间的关联.
- 识别PHPT护理级联中的特定步骤,其中存在差异.
主要方法:
- 在2021-2023年间对3976名患有高血症的成年患者进行了回顾性分析.
- 用区域贫困指数将患者分为不利,中等和有利的社区群体进行分层.
- 复制检查,副甲状腺激素 (PTH) 评估,专家转诊和副甲状腺切除术的比率.
主要成果:
- 基于邻里优势的重复或PTH评估率没有显著差异.
- 在专家推率中观察到显著的差异,优势社区的推率高 (74.9%) 与弱势地区的推率相比 (59.8%).
- 专家推成为护理途径分歧的关键点.
结论:
- 向专家推是PHPT治疗率差异的主要驱动因素.
- 需要采取干预措施来解决个人和社区的障碍,特别是在初级保健到专家过渡期间.
- 改善对甲状腺切除术的准入对于促进PHPT管理中的健康公平至关重要.
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