在医疗保险受益者中,骨折后骨质疏松症治疗的个人和社区层面的决定因素
Hongke Wu1,2, Ye Liu3,4, Jingyi Zhang1,2
1University of Alabama at Birmingham, Birmingham, AL, USA.
Journal of general internal medicine
|December 11, 2025
概括
骨折后的骨质疏松症治疗是不理想的,特别是对于男性来说. 预防性护理参与增加了治疗,而社会经济障碍和抑郁症阻碍了治疗,特别是在女性中.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 建议对骨质疏松症 (OP) 进行药理治疗,但经常未得到充分利用.
- 尽管已经确立了临床指南,但治疗率仍然低于最佳水平.
研究的目的:
- 确定影响严重骨质疏松性骨折后骨质疏松症治疗的个人和社区因素.
- 分析骨质疏松症在骨折事件发生之前和之后的治疗模式.
主要方法:
- 使用医疗保险服务费索赔 (2016-2021) 的回顾性队列研究.
- 包括65岁以上有严重骨质疏松性骨折和持续入学的受益人.
- 拉索惩罚的考克斯模型评估了预防性服务使用,健康的社会决定因素 (SDoH),人口统计和并发症等因素.
主要成果:
- 只有11.9%的人在骨折前接受了OP治疗,77.6%的人在骨折前或之后没有接受治疗.
- 预防性服务 (例如,骨密度测试,健康检查) 与骨折后的OP治疗增加有关.
- 社区的社会经济劣势和抗抑郁药的使用与治疗减少有关,观察到性别特异性差异.
结论:
- 骨折后的骨质疏松症治疗仍然不理想,特别是在男性中,突出显示了护理方面的差距.
- 预防性护理参与是启动骨折后骨质疏松症治疗的强有力的预测因素.
- 解决社区社会经济因素和抑郁症对于改善二次骨折预防至关重要.
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