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罗马尼亚不平等的区域接入ACL重建:全国性的流行病学评估 (2017-2023)
Gloria Alexandra Tolan1, Cris Virgiliu Precup2, Roxana Furau3
1Multidisciplinary Doctoral School, "Vasile Goldis" Western University of Arad, 310414 Arad, Romania.
Medicina (Kaunas, Lithuania)
|January 28, 2026
概括
罗马尼亚的前十字带重建 (ACLR) 访问显示了极端的地理不平等,在不同地区的发病率有40倍以上的差异. 社会经济因素和外科医生的可用性在很大程度上预测了ACLR率,突出了手术护理的差异.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 在全球各地的医疗保健系统中,获得前十字带重建 (ACLR) 的机会有很大差异.
- 对于东欧,特别是罗马尼亚的ACLR活动,国家层面的数据有限.
- 本研究探讨了在罗马尼亚对ACLR进行全国性评估的必要性,重点关注区域差异.
研究的目的:
- 提供罗马尼亚ACLR活动的首个全国性,区域分层评估.
- 检查ACLR中的地理差异,社会经济决定因素,劳动力影响和不平等.
- 确定ACLR发病率和私营部门利用率的预测因素.
主要方法:
- 从罗马尼亚国家行政医院数据库 (2017-2023) 中对11,080个ACLR进行了回顾性横截面分析.
- 包括人口,GDP和劳动力统计数据来分析结果,例如每10万人口的发病率.
- 使用Kruskal-Wallis,Dunn测试,多变量Poisson和物流模型以及不平等指标 (Gini,P90/P10) 的统计分析.
主要成果:
- 根据地区的ACLR发病率有很大的差异,从布加勒斯特-伊尔福的40.0/100,000到南部地区的<1-3/100,000 (p <0.001).
- 人均较高的GDP与发病率相关 (ρ = 0.36),解释了45%的差异;GDP,外科医生的可用性和私营部门的份额预测了发病率 (p < 0.001).
- 观察到极端的国家不平等 (Gini 0.842-0.752),由骨科外科医生比例 (OR 21.03) 驱动的私营部门接入.
结论:
- 罗马尼亚的ACLR表现出与社会经济发展,劳动力分配和私人医疗保健能力相关的严重领土不平等.
- 罗马尼亚各地区在获得手术护理方面存在重大差异.
- 有针对性的区域投资和协调的劳动力战略对于改善公平的ACLR准入至关重要.
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