某大城市安全网医院无住房保障患者的骨关节炎和全关节置换术

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-07-12 DOI:10.1016/j.artd.2025.101773

Abbott Gifford BA , Kelechi Nwachuku MD , Lisa Bonsignore-Opp MD , Paul Toogood MD, MS , Derek Ward MD

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引用次数: 0

摘要

背景：骨关节炎是美国老年人致残的主要原因。无家可归者的健康状况较差，患肌肉骨骼疾病的比率高于有住房的人。尽管有这种负担，PEH往往缺乏获得矫形护理的机会。该项目检查了PEH的手术结果，并调查了在护理过程中可能存在的障碍。方法对2022年扎克伯格旧金山总医院关节成形术诊所的新患者进行回顾性队列分析。患者按住房状况分组，并收集人口统计学、疾病严重程度和合并症的数据。采用描述性统计和逻辑回归进行分析。计算临床表现为PEH的患者的呈现率，并与旧金山健康计划中类似的捕获人群进行比较。结果250例患者中，4例无住房，41例住房不稳定。PEH和住房不安全感患者的kelgren - lawrence评分较差，物质使用、精神疾病、艾滋病毒和丙型肝炎病毒的比例高于稳定住房的患者。在手术进展、急诊就诊、再入院、再手术或随访方面没有差异。与参加旧金山健康计划的人相比，到诊所就诊的PEH明显减少（X2 = 11.37, P = 0.0007）。结论两组患者在手术进展和手术效果方面无差异。PEH获得关节成形术服务的频率低于住院患者。这些发现表明，研究人群中的PEH可能是良好的手术候选者，并且获得的机会有限，但结论受到短时间研究随访的限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Osteoarthritis and Total Joint Arthroplasty in Housing-Insecure Patients at a Safety Net Hospital in a Major Urban City

Background

Osteoarthritis is the leading cause of disability among older adults in the United States. People experiencing homelessness (PEH) face worse health outcomes and higher rates of musculoskeletal diseases than housed individuals. Despite this burden, PEH often lack access to orthopaedic care. This project examines surgical outcomes among PEH and investigates where in the care process barriers to access may exist.

Methods

New patient visits to the Zuckerberg San Francisco General Hospital Arthroplasty Clinic in 2022 were examined to establish a retrospective cohort. Patients were grouped by housing status, and data on demographics, disease severity, and comorbidities were collected. Analysis was performed using descriptive statistics and logistic regression. Presentation rate was calculated among clinic-presenting PEH and compared to a similarly captured population of patients on the San Francisco Health Plan.

Results

Of 250 patients, 4 were unhoused and 41 were unstably housed. PEH and housing insecurity had worse Kellgren–Lawrence scores, higher rates of substance use, mental illness, HIV, and hepatitis C virus than stably housed patients. There were no differences in surgical progression, emergency department visits, readmission, reoperation, or follow-up. Significantly fewer PEH presented to clinic compared to those on the San Francisco Health Plan (X² = 11.37, P = .0007).

Conclusions

No differences in progression to surgery or surgical outcomes were found between housing groups. PEH accessed arthroplasty services less frequently than housed individuals. These findings suggest that PEH from the study population may be good surgical candidates and have limited access, but conclusions are limited by a short study follow-up.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.