在使用子宫纤维瘤栓塞的差异
Tarig S Elhakim1,2, Sara Smolinski-Zhao2,3, Dominie Miyasato3
1Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
JAMA network open
|September 16, 2025
概括
子宫纤维瘤栓塞 (UFE) 尚未得到充分利用,基于社会经济因素,在获取上存在显著的差异. 需要努力确保公平地获得这种对子宫纤维瘤的最小侵入性治疗选择.
科学领域:
- 妇科 妇科 妇科 妇科
- 干预性放射学 干预性放射学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 子宫纤维瘤栓塞 (UFE) 为切除子宫和肌肉切除等手术治疗提供了一种最小侵入性的替代方案.
- 了解使用模式和UFE的访问差异对于知情的患者选择和公平的医疗保健至关重要.
研究的目的:
- 分析UFE在子宫纤维瘤管理中的使用趋势,与子宫切除术和肌切除术相比.
- 为了确定社会人口统计学和制度上的差异,在UFE的访问.
主要方法:
- 2016-2022年国家住院患者样本 (NIS) 数据的横截面分析.
- 使用ICD-10-CM代码识别经过子宫切除术,肌切除术或UFE的成年子宫纤维瘤患者.
- 多变量后勤回归建模用于评估与UFE利用相关的因素,控制患者和医院特征.
主要成果:
- UFE仅占手术的3.5% (9,585/271,885),其中子宫切除术是最常见的 (73.4%).
- 通过种族,种族,保险状况,收入和地理位置 (农村与城市) 观察到UFE利用的显著差异.
- 例如,非洲裔美国患者的UFE与子宫切除术的几率更高,而西班牙裔患者的两种手术比较的几率更低. 拥有医疗补助或自付保险的患者UFE的几率更高.
结论:
- 子宫纤维瘤栓塞 (UFE) 在美国显著未得到充分利用.
- 在UFE获取方面存在巨大的社会经济和人口差异,这凸显了针对性干预的必要性.
- 公平地扩大UFE的获取是必要的,以确保患者可以考虑所有有效的治疗选择子宫肌瘤.
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