Disparities in Dual-energy X-ray Absorptiometry Scan Utilization Across Race/Ethnic Groups Before and After Hip Fractures.

IF 2 Q2 ORTHOPEDICS
Katelyn E Rudisill, Philip P Ratnasamy, Joshua G Sanchez, Jonathan N Grauer
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引用次数: 0

Abstract

Background: Geriatric hip fractures are common and important sentinel events regarding bone health. Although dual x-ray absorptiometry (DEXA) scans are a standard method for determining bone density, differences in use among various race/ethnic groups around the time of hip fracture may reveal disparities within the healthcare system.

Methods: The 2014 to 2016 Medicare Standard Analytic Files PearlDiver data set was used to identify geriatric patients sustaining hip fracture. From that cohort, those who had a DEXA scan before or after their fracture were defined. For the defined cohorts, patient age, sex, Elixhauser Comorbidity Index, race/ethnicity, and income (based on zip code) were defined and compared with univariate and multivariate analyses.

Results: Of 58,099 hip fracture patients, only 19.8% had had a DEXA scan before fracture and 3.9% of the remaining group had the DEXA scan after fracture. Of the hip fracture population, 91.0% identified as White and 9.0% as non-White (Native American, Black, Hispanic, Asian, or Other). Before hip fracture, controlling for other variables and compared with White patients, all non-White categories were at lesser odds of having had the DEXA scan. After hip fracture, Black, Hispanic, and other patients were also at lesser odds of having the DEXA scan.

Discussion: Using a large Medicare data set, controlling for patient age, sex, Elixhauser Comorbidity Index, and income marker, this study revealed disparities in DEXA scan utilization across race/ethnic groups before and after presenting with a hip fragility fracture. Identification of such disparities highlights the needs for improved medical access and care for this at-risk hip fracture population.

不同种族/族裔群体在髋部骨折前后使用双能 X 射线吸收测量扫描的差异。
背景:老年髋部骨折是骨健康方面常见且重要的哨点事件。虽然双 X 射线吸收测量法(DEXA)扫描是确定骨密度的标准方法,但不同种族/族裔群体在髋部骨折发生前后使用该方法的差异可能会揭示医疗保健系统中的不平等现象:采用 2014 年至 2016 年医疗保险标准分析档案 PearlDiver 数据集来识别髋部骨折的老年患者。从该队列中定义了在骨折前后进行过 DEXA 扫描的患者。对定义的队列中的患者年龄、性别、Elixhauser 生病指数、种族/民族和收入(基于邮政编码)进行定义,并通过单变量和多变量分析进行比较:在 58099 名髋部骨折患者中,只有 19.8% 的患者在骨折前进行过 DEXA 扫描,其余 3.9% 的患者在骨折后进行过 DEXA 扫描。在髋部骨折患者中,91.0%为白人,9.0%为非白人(美国原住民、黑人、西班牙裔、亚裔或其他)。髋部骨折前,在控制其他变量的情况下,与白人患者相比,所有非白人类别接受 DEXA 扫描的几率都较低。髋部骨折后,黑人、西班牙裔和其他患者接受 DEXA 扫描的几率也较低:这项研究使用了大量的医疗保险数据集,并控制了患者的年龄、性别、Elixhauser 合并症指数和收入指标,揭示了不同种族/族裔群体在髋部脆性骨折前后使用 DEXA 扫描的差异。这种差异的发现凸显了改善髋部骨折高危人群就医和护理的必要性。
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
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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