神经神经调节采用的模式:国家许可证,地区和城市化的影响
Basil Karam1, Amy M Shui2, Shraddha Pandey1
1Department of Surgery, University of California, San Francisco, California.
The Journal of surgical research
|November 9, 2025
概括
在全国范围内,用于便失禁的圣神经调制 (SNM) 未得到充分利用. 诸如大都市居住和地区等地理因素显著影响SNM访问,而光学指令显示效果最小.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 圣神经调制 (SNM) 是用于便失禁 (FI) 的有效治疗方法.
- 国家利用和获取SNM的情况尚不清楚.
- 监管和地理因素可能会影响SNM的采用.
研究的目的:
- 调查用于便失禁的SNM使用的国家趋势.
- 评估监管和地理因素对SNM访问的影响.
- 为了确定在美国采用SNM的障碍.
主要方法:
- 使用IBM MarketScan索赔数据库 (2014-2022) 进行的回顾性队列研究.
- 确定的商业保险成年人 (18-65岁) 持续FI.
- 根据州的光学政策,地区,大都会居住地和年龄对患者进行了分层分类;使用竞争风险模型分析了SNM和口腔安置.
主要成果:
- 在62,167名患者中,SNM被放置在4.1%的患者中;1.1%接受了口腔切除.
- 大都市居住与SNM使用减少有关 (SHR:0.70).
- 与西方相比,南方的SNM使用率更高 (SHR: 1.52);加利福尼亚州的光镜授权没有显著影响使用率 (SHR: 0.77).
- 老年人 (≥59岁) 更有可能接受SNM (SHR:1.50).
结论:
- 在美国,SNM的利用不足,访问受到地理位置的严重影响.
- 阻碍SNM采用障碍包括光学任务,区域培训差异,以及大都市/西部地区的结构问题.
- 建议制定政策标准化和增加培训机会,以改善公平的SNM访问.
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