Rana Parimal, Brennan Jane C, Johnson Andrea H, Turcotte Justin J, Petre Benjamin M
Orthopedic Research, Anne Arundel Medical Center, Annapolis, USA.
Orthopedics, Anne Arundel Medical Center, Annapolis, USA.
Cureus. 2024 Jan 19;16(1):e52576. doi: 10.7759/cureus.52576. eCollection 2024 Jan.
Background Prior studies have demonstrated racial and socioeconomic disparities in patient-reported outcome measure (PROM) completion rates, and improvement exists across multiple orthopedic conditions. The purpose of this study was to assess whether these disparities are present in patients undergoing hip arthroscopy (HA) procedures. Methods A retrospective study of 306 patients undergoing HA from 2021 to 2023 was performed. Social determinants of health (SDOH) were compared between HA patients and the general Maryland population. Patients were then classified by whether they completed baseline and six-month PROMs (Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) instrument). Patients who completed PROMIS-PF were classified by whether or not they achieved minimal clinically important difference (MCID) at six months. Demographics and SDOH were compared using univariate analyses between patients who did and did not complete PROMs and between those who did and did not achieve MCID. SDOH were evaluated at the zip-code level using regional health information exchange measures. Results Compared to the Maryland population, HA patients resided in areas of lower social vulnerability. Preoperative and six-month PROMs were completed by 102 (33%) patients. No significant differences in demographics or any SDOH were found between patients who did and did not complete PROMs. Six-month MCID was achieved in 75 of 102 (74%) patients with complete PROMs; no significant differences in demographics or SDOH were observed between patients who did and did not achieve MCID. Conclusions For patients undergoing HA, disparities in patient-reported outcome completion rates and postoperative functional improvement do not appear to be present across demographics and SDOH, indicating equitable care is being delivered.
背景 先前的研究已经证明,在患者报告结局测量(PROM)完成率方面存在种族和社会经济差异,并且在多种骨科疾病中都有改善。本研究的目的是评估这些差异是否存在于接受髋关节镜检查(HA)手术的患者中。方法 对2021年至2023年接受HA手术的306例患者进行了回顾性研究。比较了HA患者与马里兰州普通人群的健康社会决定因素(SDOH)。然后根据患者是否完成基线和六个月的PROM(患者报告结局测量信息系统身体功能(PROMIS-PF)工具)进行分类。完成PROMIS-PF的患者根据他们在六个月时是否达到最小临床重要差异(MCID)进行分类。使用单变量分析比较完成和未完成PROM的患者之间以及达到和未达到MCID的患者之间的人口统计学和SDOH。使用区域健康信息交换措施在邮政编码级别评估SDOH。结果 与马里兰州人群相比,HA患者居住在社会脆弱性较低的地区。102例(33%)患者完成了术前和六个月的PROM。完成和未完成PROM的患者在人口统计学或任何SDOH方面均未发现显著差异。102例完成PROM的患者中有75例(74%)在六个月时达到了MCID;达到和未达到MCID的患者在人口统计学或SDOH方面未观察到显著差异。结论 对于接受HA手术的患者,在人口统计学和SDOH方面,患者报告结局完成率和术后功能改善的差异似乎不存在,这表明正在提供公平的医疗服务。