与微生物性角膜炎相关的社会风险因素。
Social Risk Factors Associated With Microbial Keratitis.
作者信息
Lee Madeleine C, Vogt Emily L, Hicks Patrice M, Pawar Mercy, Lu Ming-Chen, Niziol Leslie M, Terek Danielle A, Nallasamy Nambi, Hakim Farida E, Woodward Maria A
机构信息
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI.
Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI.
出版信息
Cornea. 2024 Dec 10. doi: 10.1097/ICO.0000000000003766.
PURPOSE
The objective of this study was to identify social risk factors (SRFs) that affect microbial keratitis (MK) care using the Penchansky-Thomas (P-T) health care access framework.
METHODS
This combined retrospective and prospective cohort study recruited participants with newly diagnosed MK at an academic medical center. Participant demographic information and SRFs were collected using in-person interviews and chart review. SRFs were categorized into P-T framework domains. Primary analysis included proportion of participants reporting SRFs, distribution of reported SRFs, and demographic differences associated with SRFs using descriptive statistics, chi-square, and two-sample t tests. A subgroup analysis for participants who were lost to follow-up (LTFU) was performed.
RESULTS
A total of 100 participants with MK were included in this study. Of the 100 participants, 60.0% reported at least 1 SRF affecting care, 42.0% reported ≥2 SRFs, and 12.0% reported ≥4 SRFs; 40.0% had no SRFs. More SRFs were reported for participants with lower income versus those with higher income ($25,000-$50,000 vs. $51,000-$100,000, P = 0.0363); there were no other demographic differences between groups. The most reported SRF was distance to appointment (45.0%). Accessibility was the most reported P-T domain (49.0%). Participants with LTFU, compared with those not LTFU, had more SRFs (100% vs. 52.4%, P = 0.0001) and reported a greater median number of SRFs (3.0 vs. 1.0, P < 0.0001).
CONCLUSIONS
SRFs affected most patients with MK, most notably accessibility and affordability. Participants with lower income had more SRFs. SRFs are linked to patients being lost to follow-up care.
目的
本研究的目的是使用彭钱斯基 - 托马斯（P - T）医疗保健可及性框架确定影响微生物性角膜炎（MK）治疗的社会风险因素（SRF）。
方法
这项回顾性和前瞻性队列研究相结合的研究在一家学术医疗中心招募了新诊断为MK的参与者。通过面对面访谈和病历审查收集参与者的人口统计学信息和SRF。SRF被分类到P - T框架领域。主要分析包括报告SRF的参与者比例、报告的SRF分布，以及使用描述性统计、卡方检验和双样本t检验分析与SRF相关的人口统计学差异。对失访（LTFU）的参与者进行了亚组分析。
结果
本研究共纳入100例MK患者。在这100名参与者中，60.0%报告至少有1个影响治疗的SRF，42.0%报告有≥2个SRF，12.0%报告有≥4个SRF；40.0%没有SRF。与高收入参与者相比，低收入参与者报告的SRF更多（25,000 - 50,000美元 vs. 51,000 - 100,000美元，P = 0.0363）；两组之间没有其他人口统计学差异。报告最多的SRF是预约距离（45.0%）。可及性是报告最多的P - T领域（49.0%）。与未失访的参与者相比，失访的参与者有更多的SRF（100% vs. 52.4%，P = 0.0001），并且报告的SRF中位数更多（3.0 vs. 1.0，P < 0.0001）。
结论
SRF影响了大多数MK患者，最显著的是可及性和可负担性。低收入参与者有更多的SRF。SRF与患者失访治疗有关。
Zotero 插件