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社会阶层差异对扳机指治疗的影响:31411 例分析。

Social Disparities in the Management of Trigger Finger: An Analysis of 31 411 Cases.

机构信息

The Warren Alpert Medical School of Brown University, Providence, RI, USA.

出版信息

Hand (N Y). 2023 Nov;18(8):1342-1348. doi: 10.1177/15589447221094040. Epub 2022 Jun 6.

Abstract

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 -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.

摘要

背景

成本和合规性是影响扳机指(TF)非手术和手术治疗结果的两个重要因素,这两个因素都可能受到社会因素的影响。本研究旨在调查 TF 手术治疗中的社会经济差异。

方法

使用国际疾病分类第 9 版和第 10 版临床修正诊断代码和纽约州规划和研究合作系统数据库中的当前程序术语(CPT)程序代码(CPT:26055)识别成年患者(≥18 岁)患有 TF。对每个诊断进行链接,以确定哪些患者进行 TF 松解。采用多变量逻辑回归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)、Charlson 合并症指数和主要保险类型。P 值<.05 认为差异具有统计学意义。

结果

在分析的 31411 例 TF 患者中,有 8941 例(28.5%)接受了手术。逻辑回归分析显示,女性(优势比 [OR]:1.108)和工人赔偿(OR:1.7)患者接受手术的可能性更高。西班牙裔(OR:0.541)、亚裔(OR:0.419)、非裔美国人(OR:0.455)和其他种族(OR:0.45)患者手术的可能性较低。医疗补助(OR:0.773)、医疗保险(OR:0.841)和自付(OR:0.515)报销方式降低了接受手术的可能性。较高的社会剥夺程度与手术可能性降低相关(OR:0.988)。

结论

在接受 TF 松解的患者中,与种族、主要保险和社会剥夺有关的人口统计学特征存在差异。

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本文引用的文献

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