Global Health Inequities in Orthopaedic Care: Perspectives Beyond the US.

IF 2.9 2区 医学 Q1 ORTHOPEDICS
Emily L DeMaio, Guido Marra, Linda I Suleiman, Vehniah K Tjong
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Abstract

Purpose of review: The burden of musculoskeletal disease is increasing globally and disproportionately affecting people in low and middle income countries (LMIC). We sought to review global access to orthopaedic care, burden of trauma, research infrastructure, impact of surgical mission trips, implant availability, and the effect of COVID-19 upon the delivery of orthopaedic care worldwide.

Recent findings: The majority of people in LMIC do not have access to safe, quality surgical care, and there are few fellowship-trained orthopaedic traumatologists. Road traffic accidents are the leading cause of long bone fractures in LMIC and result in significant morbidity and mortality. Of the orthopaedic literature published globally in the last 10 years, less than 15% had authors from LMIC. There has been growth in surgical mission trips to LMIC, but few organizations have established bidirectional partnerships. Among the challenges to delivering quality musculoskeletal care in LMIC is timely access to quality orthopaedic implants. Implant options in LMIC are more limited and subjected to less rigorous testing and regulation than high income countries (HIC). The COVID-19 pandemic dramatically reduced elective surgeries but saw the increase in telemedicine utilization which has prevailed in both HIC and LMIC. Awareness of global inequities in orthopaedic care is growing. Much can be learned through collaborations between orthopaedic surgeons from HIC and LMIC to advance patient care worldwide. There is a need for high quality, accurate data regarding incidence and prevalence of musculoskeletal disease, care utilization/availability, and postoperative outcomes so resources can be allotted to make orthopaedic care more equitable globally.

矫形外科护理中的全球健康不平等:美国以外的视角。
审查目的:在全球范围内,肌肉骨骼疾病的负担日益加重,对中低收入国家(LMIC)人民的影响尤为严重。我们试图回顾全球骨科医疗服务的可及性、创伤负担、研究基础设施、手术任务旅行的影响、植入物的可用性以及 COVID-19 对全球骨科医疗服务的影响:最近的研究结果:在低收入和中等收入国家,大多数人无法获得安全、优质的外科医疗服务,而且接受过研究员培训的创伤骨科医生也很少。在低收入国家,道路交通事故是造成长骨骨折的主要原因,并导致严重的发病率和死亡率。在过去 10 年全球发表的骨科文献中,只有不到 15%的作者来自低收入和中等收入国家。前往低收入国家和地区的手术任务有所增加,但很少有组织建立起双向合作关系。在低收入国家和地区提供高质量的肌肉骨骼治疗所面临的挑战之一是及时获得高质量的骨科植入物。与高收入国家(HIC)相比,低收入国家(LMIC)的植入物选择更为有限,所接受的测试和监管也没有那么严格。COVID-19 大流行大大减少了选择性手术,但远程医疗的使用却有所增加,这在高收入国家和低收入国家都很普遍。人们越来越意识到全球骨科医疗的不平等。通过来自高收入国家和低收入国家的骨科外科医生之间的合作,我们可以学到很多东西,从而在全球范围内促进对患者的护理。我们需要有关肌肉骨骼疾病的发病率和流行率、护理利用率/可用性以及术后效果的高质量准确数据,以便分配资源,使全球骨科护理更加公平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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