Susanna Howard, Ellie Gabriel, Ritesh Karsalia, Dominick Macaluso, Jesse Y Hsu, Liming Qiu, Neil R Malhotra, Iahn Cajigas, Whitley Aamodt, John Farrar
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引用次数: 0
Abstract
Background: Prior studies suggest that patients with essential tremor (ET) have increased rates of healthcare utilization, but the reason for this increased use is unknown. The objective of this study was to evaluate the reasons for healthcare use among ET patients.
Methods: This was a retrospective cross-sectional study of ET patients with an admission or emergency department (ED) visit at a tertiary health system from 2018-2023. Patients were matched on an encounter level with control patients based on propensity scores incorporating age, sex, race, and co-morbid conditions. The primary outcome was the odds of an encounter for each diagnostic category comparing ET patients with matched controls.
Results: Only inpatient admissions for neurologic diagnoses were more likely for ET compared to control patients (odds ratio (OR) 3.73, 95% confidence interval (CI) 2.54 - 5.49, p < 0.001). Once admissions related to the surgical treatment of tremor were excluded, admissions for neurologic diagnoses were equally likely among ET and control patients (OR 0.96, 95% CI 0.59 - 1.57, p = 0.88).
Discussion: Surgical treatment of tremor appears to be a key driver of healthcare use among ET patients. Future investigations should examine the pattern of healthcare use of ET patients before and after surgery.
Highlights: Prior studies have shown increased healthcare use among essential tremor (ET) patients. The objective of this study was to evaluate the reasons for healthcare use among ET patients compared to matched control patients. Surgical treatment of tremor was found to be a key driver of healthcare use among ET patients.
背景:先前的研究表明,本质性震颤(ET)患者的医疗保健使用率会增加,但使用率增加的原因尚不清楚。本研究旨在评估 ET 患者使用医疗服务的原因:这是一项回顾性横断面研究,研究对象是 2018-2023 年期间在一家三级医疗系统入院或急诊科(ED)就诊的 ET 患者。根据纳入年龄、性别、种族和并发症的倾向评分,在就诊层面将患者与对照组患者进行匹配。主要结果是将 ET 患者与匹配的对照组患者进行比较,得出每个诊断类别的就诊几率:与对照组患者相比,ET 患者仅因神经系统诊断住院的几率更高(几率比 (OR) 3.73,95% 置信区间 (CI) 2.54 - 5.49,P < 0.001)。一旦排除与震颤手术治疗相关的入院病例,ET患者和对照组患者因神经系统诊断入院的可能性相同(OR 0.96,95% CI 0.59 - 1.57,P = 0.88):讨论:震颤的外科治疗似乎是 ET 患者使用医疗服务的主要原因。讨论:手术治疗震颤似乎是 ET 患者使用医疗服务的主要驱动因素,未来的调查应研究 ET 患者在手术前后使用医疗服务的模式:亮点:先前的研究显示,本质性震颤(ET)患者使用医疗服务的情况有所增加。本研究旨在评估 ET 患者与匹配的对照组患者相比使用医疗服务的原因。研究发现,震颤的手术治疗是导致 ET 患者使用医疗服务的主要原因。