31 411例扳机指治疗的社会差异分析

The Hand Pub Date : 2023-11-01 Epub Date: 2022-06-06 DOI:10.1177/15589447221094040
Peter G Brodeur, Jeremy E Raducha, Kang Woo Kim, Cameron Johnson, Elliott Rebello, Aristides I Cruz, Joseph A Gil
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引用次数: 0

摘要

背景成本和依从性是影响扳机指非手术和手术治疗结果的两个因素,两者都可能受到社会因素的影响。本研究的目的是调查TF手术治疗中的社会经济差异。方法使用纽约州规划与研究合作系统中的国际疾病分类9和10 TF临床改良诊断代码和当前程序术语(CPT)程序代码(CPT:26055)来确定成年患者(≥18岁)数据库每个诊断都与程序数据相关联,以确定哪些患者继续进行TF释放。采用多变量逻辑回归来评估接受手术的可能性。纳入分析的变量包括年龄、性别、种族、社会剥夺指数(SDI)、查尔森共病指数和初级保险类型。P值<0.05被认为是显著的。结果31 411名TF患者接受了分析,其中8941人(28.5%)接受了手术。Logistic回归分析显示,女性接受手术的几率更高(比值比[OR]:1.108),而那些有工人补偿的女性接受手术(比值比:1.7)。西班牙裔(比值比0.541)、亚裔(比值比0.419)、非裔美国人(比值比:0.455)和其他种族(比值比0.45)的手术几率降低。医疗补助(OR:0.773)、医疗保险(OR:0.841)和自费(OR:0.515)报销方法降低了接受手术的几率。社会剥夺程度越高,手术几率越低(OR:0.988)。结论接受扳机指TF释放的患者的人口统计学特征存在差异,这与种族、初级保险和社会剥夺有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Social Disparities in the Management of Trigger Finger: An Analysis of 31 411 Cases.

Background: Cost and compliance are 2 factors that can significantly affect the outcomes of non-operative and operative treatment of trigger finger (TF) and both may be influenced by social factors. The purpose of this study was to investigate socioeconomic disparities in the surgical treatment for TF.

Methods: Adult patients (≥18 years old) were identified using International Classification of Diseases 9 and 10 Clinical Modification diagnostic codes for TF and Current Procedural Terminology (CPT) procedural codes (CPT: 26055) in the New York Statewide Planning and Research Cooperative System database. Each diagnosis was linked to procedure data to determine which patients went on to have TF release. A multivariable logistic regression was performed to assess the likelihood of receiving surgery. The variables included in the analysis were age, sex, race, social deprivation index (SDI), Charlson Comorbidity Index, and primary insurance type. A P-value < .05 was considered significant.

Results: Of the 31 411 TF patients analyzed, 8941 (28.5%) underwent surgery. Logistic regression analysis showed higher odds of receiving surgery in females (odds ratio [OR]: 1.108) and those with workers compensation (OR: 1.7). Hispanic (OR: 0.541), Asian (OR: 0.419), African American (OR: 0.455), and Other race (OR: 0.45) had decreased odds of surgery. Medicaid (OR: 0.773), Medicare (OR: 0.841), and self-pay (OR: 0.515) reimbursement methods had reduced odds of receiving surgery. Higher social deprivation was associated with decreased odds of surgery (OR: 0.988).

Conclusions: There are disparities in demographic characteristics among those who receive TF release for trigger finger related to race, primary insurance, and social deprivation.

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