社会经济学对状细胞患者胆道疾病的影响
Jeduthun Harris1, Ahmad Zeineddin1, Sandy Li1
1General Surgery, Howard University Hospital, Washington DC, USA.
与私人保险相比,接受胆囊手术的状细胞病 (SCD) 患者在医疗保险和医疗补助计划中出现并发症风险更高. 社会经济因素对SCD患者的结果产生重大影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
- 血液学 血液学 血液学
背景情况:
- 状细胞病 (SCD) 影响10万美国人,导致每年134,000例住院治疗和11亿美元的费用.
- 胆囊切除术是SCD患者中常见的手术手术.
- 需要评估社会经济因素对SCD患者术后结果的影响.
研究的目的:
- 评估社会经济因素对接受胆囊切除术的状细胞病患者外科期结局的影响.
- 分析保险类型和医院环境如何影响该患者群体的并发症率.
主要方法:
- 从2006年至2015年使用了全国住院患者样本 (NIS) 数据库.
- 包括1779名被诊断患有SCD和胆囊疾病的患者.
- 根据保险状况 (医疗补助,医疗保险,私人) 和医院类型 (城市教学) 分层患者.
- 评估结果包括外科手术期间血管闭塞危机 (VOC),术后发病率和死亡率.
主要成果:
- 大多数患者有医疗补助 (49%) 并在城市教学医院接受治疗 (75%).
- 在拥有私人保险的患者中,并发症率最低.
- 后勤回归显示,与私人保险相比,Medicare (1.57) 和Medicaid (1.51) 患者的VOC几率明显更高.
结论:
- 大多数接受胆囊切除术的SCD患者都受到医疗补助,并在城市教学医院接受护理.
- 在私人保险中,外科手术期间的VOC率最低,而在医疗保险和医疗补助中则高得多.
- 社会经济因素,特别是保险类型,在SCD患者的术后结果中发挥着关键作用.
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