在少数群体人口统计学中,手部皮质类固醇注射和关节塑形术的使用不足
Christopher M Dussik1, Amy Phan1, Akhil Dondapati1
1Department of Orthopaedic Surgery, University of Rochester School of Medicine, Rochester, NY.
Journal of hand surgery global online
|October 23, 2025
概括
种族和族裔少数群体接受的皮质类固醇注射和手部骨关节炎的手术治疗较少. 即使控制了其他健康因素,这些差异仍然存在,凸显了护理方面的不平等.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 类风湿病学 类风湿病学
背景情况:
- 手部关节炎 (OA) 管理在手部手术中至关重要.
- 皮质类固醇注射和手术是严重手部OA的主要治疗方法.
- 存在着公认的医疗保健差异,特别是在疼痛管理方面.
研究的目的:
- 调查手部OA治疗中的种族和民族差异.
- 为了在不同的人口群体中比较皮质类固醇注射和外科手术干预率.
主要方法:
- 利用TrinetX数据库 (2010-2024) 对手部骨质炎患者进行研究.
- 通过诊断和计费代码识别患者.
- 评估医疗保健使用率,皮质类固醇注射率和按种族/民族分层的手术率.
- 雇佣匹配以控制混变量和使用赔率比率.
主要成果:
- 鉴定了896,636名手部骨髓炎患者.
- 非西班牙裔白人患者接受皮质类固醇注射的几率更高 (几乎是2倍).
- 与少数群体相比,非西班牙裔白人患者的手术治疗率始终较高.
- 在对人口统计和并发症进行匹配后,差异仍然存在,尽管医疗保健利用率相似.
结论:
- 少数群体的人口统计学对手部OA的皮质类固醇注射较少.
- 在代表性不足的少数群体中,手术管理率要低得多.
- 持续的治疗差异强调了在上肢护理中解决健康的社会决定因素的必要性.
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