在美国军事卫生系统的患者中完成关节整形的时间
Brandon L Hillery1, Ashton H Goldman2,3, Alexander G Velosky4,5,6
1School of Medicine, Uniformed Services University, Bethesda, Maryland.
JAMA network open
|October 28, 2025
概括
关节整形术 (THA) 的延迟会影响患者的治疗结果. 这项研究根据患者人口统计,护理因素和医疗保健系统结构发现了THA时间的显著变化,突出了改善获取的领域.
科学领域:
- 整形外科 整形外科 整形外科
- 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:
- 全关节整形术 (THA) 是关节骨关节炎的常见手术.
- 在THA的延迟可能导致负面的患者结果.
- 了解影响THA时间的因素对于改善美国军事卫生系统内的护理提供至关重要.
研究的目的:
- 为了评估关节骨关节炎诊断后THA的时间.
- 为了确定与THA定时相关的患者,护理和结构层面的因素.
主要方法:
- 成年TRICARE注册人的回顾性队列研究.
- 分析来自军事和民用医疗保健设施的医疗记录 (2015年3月 - 2024年6月).
- 统计建模以评估时间与THA的发病率比率.
主要成果:
- 在37239名患者中,28%的患者在诊断后3年内接受了THA.
- 在种族/民族少数群体,患有先前存在的疾病 (精神病,疼痛,肥胖) 和购买护理系统中的患者中观察到较低的THA发病率.
- 在退役军人,家庭成员和男性中发现了较高的THA发病率.
- 增加THA的可能性与更多的骨科访问,阿片类药物处方和诊断后成像相关.
结论:
- 在TRICARE登记者中,THA收件存在显著的多层次变化.
- 政策和规划应考虑地理因素,结构因素和报销模式,以优化THA访问.
- 解决发现的差异可以改善及时获得全关节整形手术的机会.
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