由于盆地底疾病而接受手术的患者的医疗保健差异:系统性审查
Cecilia K Wieslander1, Cara L Grimes, Ethan M Balk
1Division of Urogynecology, Departments of Obstetrics & Gynecology and Urology, David Geffen School of Medicine at UCLA, and the Division of Urogynecology, Departments of Obstetrics & Gynecology and Urology, UCLA Health, Los Angeles, and the Division of Urogynecology, Department of Obstetrics & Gynecology, Olive View-UCLA Medical Center, Sylmar, California; the Department of Obstetrics and Gynecology, Albany Medical College, Albany, New York; the Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Louisville Health, Louisville, Kentucky; the Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Florida Health, Jacksonville, Florida; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Texas at Austin Dell Medical School, Austin, Texas; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, Baylor College of Medicine, and the Division of Urogynecology, Department of Obstetrics & Gynecology, Houston Methodist Hospital, Houston, Texas; the Department of Obstetrics & Gynecology, Wayne State University School of Medicine, Detroit, Michigan; the Division of Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut; the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, Howard University College of Medicine, Washington, DC; the Division of Urogynecology & Reconstructive Pelvic Surgery, Cooper Health University, Cooper Medical School at Rowan University, Camden, New Jersey; Boston Urogyn, Wellesley, Massachusetts; and the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, New Mexico.
骨盆底疾病的手术治疗揭示了差异. 少数群体,医疗保险患者和东北地区以外的人在美国面临更大的医疗保健准入和结果挑战.
科学领域:
- 泌尿后科和骨盆重建外科手术
- 医疗保健服务研究 医疗服务研究
- 健康差距 研究 研究 研究 研究
背景情况:
- 骨盆底疾病 (PFDs) 影响了女性人口的很大一部分.
- 手术干预是PFD的常见治疗方法.
- 了解影响获取和结果的因素对于公平护理至关重要.
研究的目的:
- 检查与医疗保健差异相关的患者特征之间的关联,以及PFDs获得外科治疗的机会.
- 调查这些差异如何影响PFD手术后的临床结果.
- 综合关于PFD手术护理中的种族,种族,地点和保险状况的证据.
主要方法:
- 在2024年3月之前对MEDLINE,EMBASE和ClinicalTrials.gov进行系统审查.
- 包括报告PFD手术结果的多变量回归分析的研究.
- 分析了差异 (种族,族裔,地点,保险) 与获取,手术结果和患者报告结果之间的关联.
主要成果:
- 包括42项研究,包括84项多变量分析.
- 少数民族的种族/族裔和农村地区的位置与减少某些形手术的机会有关.
- 医疗保险和年龄较大与增加的并发症风险相关.
- 少数民族种族与压力性尿失禁手术后的再手术率较低有关.
结论:
- 在美国,对于PFD的手术治疗存在显著的医疗差异.
- 少数群体,医疗保险受益者和东北地区以外的个人经历了更糟糕的获取和结果.
- 解决这些差异对于改善对所有PFD患者的护理至关重要.
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