低收入、年轻、女性和心理健康状况不佳是半月板撕裂患者就诊机会减少的危险因素

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.asmr.2024.101064

Drew W. Barron B.S. , Vikram S. Gill B.S. , Sayi P. Boddu B.A. , Nathan C. Beckett B.S. , Sailesh V. Tummala M.D. , Anikar Chhabra M.D.

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引用次数: 0

摘要

目的利用All of Us数据库调查半月板撕裂患者获得医疗保健的障碍，并研究特定的人口统计学、社会经济和健康相关因素如何独立影响其医疗保健利用。方法查询2017年3月至2023年3月期间美国国立卫生研究院All of Us数据库的患者数据，形成半月板撕裂患者队列。患者半月板撕裂确定使用系统命名法医学临床术语。所有自我报告半月板撕裂的患者均被纳入研究，没有排除标准以确保未被充分代表的个体的多样化代表。对“医疗保健访问和利用调查”的患者反应进行了4个方面的分析：“延迟护理”、“负担不起护理费用”、“跳过药物治疗”和“一年多没有去看医生”。结果从43.6万份符合条件的记录中，共纳入5671名半月板撕裂患者进行分析。其中，27.7%的人报告延迟就医，23.9%的人无法负担医疗费用，11.8%的人跳过药物治疗，2.0%的人一年多没有去看医生。年收入低于5万美元的患者更有可能延迟护理(优势比[OR]， 1.41；P & lt;.001)，无法负担医疗费用(OR, 1.73；P & lt;.001)，或不服药(or, 1.79；P & lt;措施)。年龄小于队列平均年龄65.4岁、女性以及身体和心理健康状况不佳与至少1个护理领域的可及性受损相关。超过四分之一的被诊断为半月板撕裂的患者对我们所有人的“医疗保健获取和利用调查”做出了回应，他们报告了在四个领域获得医疗服务的困难，其中低收入、年轻、女性、精神或身体健康状况不佳的患者在获得医疗服务方面遇到了重大障碍。本研究通过强调骨科护理获取和利用的差异，可以为公平治疗半月板损伤的策略提供信息。

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Low Income, Younger Age, Female Sex, and Poor Mental Health Are Risk Factors for Diminished Access to Care Among Patients With Meniscus Tears

Purpose

To use the All of Us database to investigate barriers to health care access for patients with meniscus tears and to examine how specific demographic, socioeconomic, and health-related factors independently influence their health care utilization.

Methods

The National Institutes of Health All of Us database was queried for patient data between March 2017 and March 2023 to form a cohort of patients with meniscal tears. Patients with meniscal tears were identified using Systematized Nomenclature of Medicine clinical terms. All patients with self-reported meniscus tears were included, with no exclusion criteria to ensure a diverse representation of underrepresented individuals. Patient responses to the “Healthcare Access and Utilization Survey” were analyzed across 4 domains: “delayed care,” “could not afford care,” “skipped medication,” and “have not seen a provider in over one year.”

Results

In total, 5,671 survey respondents with meniscal tears were included for analysis from a population of 436,000 eligible records. Among them, 27.7% reported delayed care, 23.9% were unable to afford care, 11.8% skipped medication, and 2.0% had not seen a provider in over a year. Patients with annual incomes under $50,000 were more likely to delay care (odds ratio [OR], 1.41; P < .001), be unable to afford care (OR, 1.73; P < .001), or skip medications (OR, 1.79; P < .001). Younger age than the cohort mean of 65.4 years, female sex, and poor physical and mental health were associated with impaired access in at least 1 care domain.

Conclusions

Over one-fourth of patients with a diagnosis of meniscus tear who responded to the All of Us “Healthcare Access and Utilization Survey” reported difficulties with access to care across 4 domains, with those of low income, younger age, female sex, and poor mental or physical health experiencing significant barriers to care.

Clinical Relevance

This research can inform strategies for equitable treatment of meniscal injuries by highlighting disparities in orthopaedic care access and utilization.

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