慢性鼻窦炎患者获得护理的障碍

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-07-16 DOI:10.1002/lio2.70202

Faizaan I. Khan, Najm S. Khan, Heli Majeethia, Jihwan Park, Roshan Dongre, Franklin Wu, Ella Brissett, Masayoshi Takashima, Omar G. Ahmed

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引用次数: 0

摘要

本研究旨在比较性少数和性别少数（SGM）患者和非SGM慢性鼻窦炎（CRS）患者获得医疗保健的成本和非成本障碍的流行程度。方法查询All of Us研究计划的CRS患者，定义为至少有两种慢性鼻窦炎诊断（ICD10: J32.x）。根据性别认同、生理性别和自我描述等问题对患者进行分类。主要结果是成本壁垒和非成本壁垒。多变量逻辑回归用于检查SGM状态和经历护理障碍。结果共纳入CRS患者7708例；SGM 595例，非SGM 7113例。SGM患者更有可能延迟初级保健（AOR: 1.51, 95% CI: 1.09-2.11）、专科护理（AOR: 1.54, 95% CI: 1.18-2.00）、精神保健（AOR: 1.70, 95% CI: 1.29-2.24）和服用处方药（AOR: 1.31, 95% CI: 1.03-1.66）。在非成本障碍方面，SGM患者更有可能因为交通问题（AOR: 1.84, 95% CI: 1.39-2.42）、他们的提供者具有不同的背景（AOR: 1.48, 95% CI: 1.14-1.90）以及由于他们的提供者缺乏尊重（AOR: 1.42, 95% CI: 1.16-1.73）而延迟护理。结论SGM合并CRS患者存在多重成本和非成本障碍。虽然CRS组和非CRS组之间的差异不大，但鼻科医生和其他治疗伴有CRS的SGM患者的医疗从业人员应该注意这些差异，以在患者和系统层面解决这些障碍。证据等级III级，2025年。

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Obstacles to Obtain Care Among Sexual and Gender Minorities With Chronic Rhinosinusitis

Objectives

This study aims to compare the prevalence of cost and non-cost barriers to healthcare access among sexual and gender minority (SGM) patients and non-SGM patients with chronic rhinosinusitis (CRS).

Methods

The All of Us Research Program was queried for CRS patients, defined as having at least two diagnoses of chronic sinusitis (ICD10: J32.x). Patients were categorized based on questions regarding gender identity, biological sex, and self-descriptions. The primary outcome was cost and non-cost barriers. Multivariable logistic regression was used to examine SGM status and experiencing barriers to care.

Results

7708 patients with CRS were included; 595 were SGM and 7113 were non-SGM. SGM patients were significantly more likely to delay primary care (AOR: 1.51, 95% CI: 1.09–2.11), specialist care (AOR: 1.54, 95% CI: 1.18–2.00), mental healthcare (AOR: 1.70, 95% CI: 1.29–2.24), and filling prescription medication (AOR: 1.31, 95% CI: 1.03–1.66). Regarding non-cost barriers, SGM patients were significantly more likely to delay care because of transportation problems (AOR: 1.84, 95% CI: 1.39–2.42), their provider having a different background (AOR: 1.48, 95% CI: 1.14–1.90) and due to a lack of respect by their providers (AOR: 1.42, 95% CI: 1.16–1.73).

Conclusion

SGM patients with CRS report multiple cost and non-cost barriers. While differences between CRS and non-CRS groups were modest, rhinologists and other healthcare practitioners treating SGM patients with CRS should be mindful of these disparities to address these barriers at a patient and system level.