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社会决定因素对健康的影响:疼痛诊疗预约患者倾向性模型的建立与靶向治疗。

Social determinants of health: modeling and targeting patient propensity to attend pain clinic appointments.

机构信息

Department of Anesthesiology, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, USA.

Department of Anesthesiology, Cornell Medical Center, New York, NY 10065, USA.

出版信息

Pain Manag. 2023 Mar;13(3):151-159. doi: 10.2217/pmt-2022-0059. Epub 2023 Jan 31.

Abstract

We sought to investigate the impact of social determinants of health on pain clinic attendance. Retrospective data were collected from the Pain Center at Montefiore Medical Center from 2016 to 2020 and analyzed with multivariable logistic regression. African-Americans were less likely to attend appointments compared with White patients (odds ratio [OR]: 0.73; 95% CI: 0.70-0.77; p < 0.001). Males had decreased attendance compared with females (OR: 0.89; 95% CI: 0.87-0.92; p < 0.001). Compared with commercial, those with Medicaid (OR: 0.69; 95% CI: 0.66-0.72; p < 0.001) and Medicare (OR: 0.76; 95% CI: 0.73-0.80; p < 0.001) insurance had decreased attendance. Significant disparities exist in pain clinic attendance based upon social determinants of health including race, gender and insurance type.

摘要

我们旨在研究健康的社会决定因素对疼痛诊所就诊率的影响。从 2016 年到 2020 年,我们从 Montefiore 医疗中心的疼痛中心收集了回顾性数据,并通过多变量逻辑回归进行了分析。与白人患者相比,非裔美国人就诊的可能性较低(优势比 [OR]:0.73;95%CI:0.70-0.77;p<0.001)。与女性相比,男性就诊的可能性降低(OR:0.89;95%CI:0.87-0.92;p<0.001)。与商业保险相比,医疗补助(OR:0.69;95%CI:0.66-0.72;p<0.001)和医疗保险(OR:0.76;95%CI:0.73-0.80;p<0.001)的患者就诊率降低。基于健康的社会决定因素,包括种族、性别和保险类型,疼痛诊所的就诊率存在显著差异。

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