Brown Ethan D L, Williams Greer M, Maity Apratim, Ward Max, Schneider Daniel, Sciubba Daniel M, Larry Lo Sheng-Fu
Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Global Spine J. 2025 Jan 30:21925682251318262. doi: 10.1177/21925682251318262.
Study DesignCross-Sectional Survey.ObjectiveThis study aimed to assess racial disparities in self-reported barriers to care, health literacy, and health status within a large cohort of cervical stenosis patients.MethodsThis cross-sectional study used ICD-9 and ICD-10 codes to identify cervical stenosis patients recorded in the NIH All of Us Research Program between 2017 and 2022. Demographic information and self-reported measures of health status, health literacy, and perceived barriers to care were compared among White, Black, and Hispanic patients using Chi square tests.ResultsOf 5480 patients identified, 658 (12.0) were Black, 379 (6.9) Hispanic, and 4443 (81.1) White. White patients were more likely to possess college education ( < .001), income >$50k per year ( < .001), and non-disabled employment status ( < .001). Black and Hispanic patients reported higher levels of 7-10 pain ( < .001), "severe" 7-day fatigue ( < .001), and poor general health ( < .001). Black and Hispanic patients also reported greater difficulties understanding medical information ( < .001) and navigating medical forms alone ( < .001). Black and Hispanic patients were likelier to report delaying care due to unaffordable copays ( < .001), transportation difficulties ( < .001), or dissimilar provider background. Provider background was more likely to be described as "very important" by Black and Hispanic patients ( < .001).ConclusionThis study identified significant disparities in health status, health literacy, and access to care among patients with cervical stenosis, highlighting diverse patient perspectives on barriers to care which may warrant further study.
研究设计
横断面调查。
目的
本研究旨在评估一大群颈椎管狭窄患者在自我报告的就医障碍、健康素养和健康状况方面的种族差异。
方法
这项横断面研究使用ICD - 9和ICD - 10编码来识别2017年至2022年期间记录在国立卫生研究院“我们所有人”研究项目中的颈椎管狭窄患者。使用卡方检验比较白人、黑人及西班牙裔患者的人口统计学信息以及自我报告的健康状况、健康素养和就医感知障碍。
结果
在识别出的5480名患者中，658名（12.0%）为黑人，379名（6.9%）为西班牙裔，4443名（81.1%）为白人。白人患者更有可能拥有大学学历（P <.001）、年收入超过5万美元（P <.001）以及非残疾就业状态（P <.001）。黑人和西班牙裔患者报告的7 - 10级疼痛水平更高（P <.001）、“严重”的7天疲劳程度更高（P <.001）以及总体健康状况较差（P <.001）。黑人和西班牙裔患者还报告在理解医疗信息方面困难更大（P <.001）以及独自填写医疗表格困难更大（P <.001）。黑人和西班牙裔患者更有可能报告因自付费用过高（P <.001）、交通困难（P <.001）或提供者背景不同而延迟就医。黑人和西班牙裔患者更有可能将提供者背景描述为“非常重要”（P <.001）。
结论
本研究发现颈椎管狭窄患者在健康状况、健康素养和就医机会方面存在显著差异，突出了患者对就医障碍的不同看法，这可能值得进一步研究。
