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医疗服务欠缺的里奥格兰德河谷地区的糖尿病负担

Burden of Diabetes Mellitus in the Medically Underserved Rio Grande Valley.

作者信息

Gaddis John M, Arellano Elias, Pulido Kassandra, Torres Tyler, Chau-Zanetti Dominic, Quailes Natasha, Suarez Parraga Andres R

机构信息

Orthopedic Surgery, University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.

Internal Medicine, University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.

出版信息

Cureus. 2024 Sep 24;16(9):e70088. doi: 10.7759/cureus.70088. eCollection 2024 Sep.

Abstract

Introduction Diabetes mellitus (DM) encompasses metabolic disorders characterized by elevated blood sugar. This study aimed to evaluate the prevalence and associated metrics of DM in the Rio Grande Valley (RGV), a low-income and medically underserved region in the United States, and compare these metrics to the national averages from 2012 to 2022. Methods  A retrospective cross-sectional analysis was conducted using publicly accessible data from the Centers for Medicare and Medicaid Services (CMS). Metrics analyzed included DM prevalence, average principal cost, rates of emergency department visits, hospitalizations, screenings, and prevalence of obesity. Data from the RGV counties were compared to national averages using Mann-Whitney U tests, with a p-value of <0.05 considered significant. Results From 2012 to 2022, DM affected patients in the RGV (43.95%) at significantly higher rates than the national average (26.73%) (p < 0.001). Obesity prevalence in the RGV was at higher rates than the national average (24.41% vs. 15.55%, p < 0.01). The screening rates of DM exceeded the national average (10.64% vs. 5.09%, p < 0.001). The average principal cost for patients in the RGV ($1,920.45) to treat DM was significantly greater than the national average principal cost ($859.64) (p < 0.001). The RGV also reported higher rates of ED visits (16.82 vs. 8.82 per 1,000 beneficiaries, p < 0.001) and hospitalizations (7.75 vs. 3.82 per 1,000 beneficiaries, p < 0.001). Conclusion The RGV exhibits significantly higher rates of DM and DM-associated metrics compared to the national averages, highlighting substantial public health disparities.

摘要

引言 糖尿病(DM)涵盖以血糖升高为特征的代谢紊乱。本研究旨在评估美国低收入且医疗服务不足的里奥格兰德河谷(RGV)地区糖尿病的患病率及相关指标,并将这些指标与2012年至2022年的全国平均水平进行比较。方法 使用医疗保险和医疗补助服务中心(CMS)公开可得的数据进行回顾性横断面分析。分析的指标包括糖尿病患病率、平均主要费用、急诊科就诊率、住院率、筛查率和肥胖患病率。使用曼-惠特尼U检验将RGV各县的数据与全国平均水平进行比较,p值<0.05被认为具有统计学意义。结果 2012年至2022年期间,RGV地区受糖尿病影响的患者比例(43.95%)显著高于全国平均水平(26.73%)(p<0.001)。RGV地区的肥胖患病率高于全国平均水平(24.41%对15.55%,p<0.01)。糖尿病的筛查率超过全国平均水平(10.64%对5.09%,p<0.001)。RGV地区患者治疗糖尿病的平均主要费用(1920.45美元)显著高于全国平均主要费用(859.64美元)(p<0.001)。RGV地区的急诊科就诊率(每1000名受益人中有16.82次对8.82次,p<0.001)和住院率(每1000名受益人中有7.75次对3.82次,p<0.001)也更高。结论 与全国平均水平相比,RGV地区的糖尿病及糖尿病相关指标发生率显著更高,凸显了巨大的公共卫生差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc89/11500487/bf3ee415b4b9/cureus-0016-00000070088-i01.jpg

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