Barron Drew W, Gill Vikram S, Boddu Sayi P, Beckett Nathan C, Tummala Sailesh V, Chhabra Anikar
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Dec 12;7(2):101064. doi: 10.1016/j.asmr.2024.101064. eCollection 2025 Apr.
To use the All of Us database to investigate barriers to health care access for patients with meniscus tears and to examine how specific demographic, socioeconomic, and health-related factors independently influence their health care utilization.
The National Institutes of Health All of Us database was queried for patient data between March 2017 and March 2023 to form a cohort of patients with meniscal tears. Patients with meniscal tears were identified using Systematized Nomenclature of Medicine clinical terms. All patients with self-reported meniscus tears were included, with no exclusion criteria to ensure a diverse representation of underrepresented individuals. Patient responses to the "Healthcare Access and Utilization Survey" were analyzed across 4 domains: "delayed care," "could not afford care," "skipped medication," and "have not seen a provider in over one year."
In total, 5,671 survey respondents with meniscal tears were included for analysis from a population of 436,000 eligible records. Among them, 27.7% reported delayed care, 23.9% were unable to afford care, 11.8% skipped medication, and 2.0% had not seen a provider in over a year. Patients with annual incomes under $50,000 were more likely to delay care (odds ratio [OR], 1.41; < .001), be unable to afford care (OR, 1.73; < .001), or skip medications (OR, 1.79; < .001). Younger age than the cohort mean of 65.4 years, female sex, and poor physical and mental health were associated with impaired access in at least 1 care domain.
Over one-fourth of patients with a diagnosis of meniscus tear who responded to the All of Us "Healthcare Access and Utilization Survey" reported difficulties with access to care across 4 domains, with those of low income, younger age, female sex, and poor mental or physical health experiencing significant barriers to care.
This research can inform strategies for equitable treatment of meniscal injuries by highlighting disparities in orthopaedic care access and utilization.
利用“我们所有人”数据库调查半月板撕裂患者获得医疗服务的障碍,并研究特定的人口统计学、社会经济和健康相关因素如何独立影响他们的医疗服务利用情况。
查询美国国立卫生研究院“我们所有人”数据库2017年3月至2023年3月期间的患者数据,以形成半月板撕裂患者队列。使用医学系统命名法临床术语识别半月板撕裂患者。纳入所有自我报告有半月板撕裂的患者,无排除标准,以确保代表性不足个体的多样化呈现。对患者对“医疗服务获取与利用调查”的回答在4个领域进行分析:“延迟就医”、“无力支付医疗费用”、“漏服药物”和“一年多未就医”。
在436,000条合格记录的人群中,共有5671名报告有半月板撕裂的调查受访者纳入分析。其中,27.7%报告延迟就医,23.9%无力支付医疗费用,11.8%漏服药物,2.0%一年多未就医。年收入低于5万美元的患者更有可能延迟就医(优势比[OR],1.41;P <.001)、无力支付医疗费用(OR,1.73;P <.001)或漏服药物(OR,1.79;P <.001)。年龄低于队列平均年龄65.4岁、女性以及身心健康状况较差与至少1个医疗领域的就医障碍有关。
在对“我们所有人”的“医疗服务获取与利用调查”做出回应的半月板撕裂诊断患者中,超过四分之一的患者报告在4个领域获得医疗服务存在困难,低收入、年轻、女性以及心理或身体健康状况较差的患者在获得医疗服务方面存在重大障碍。
本研究通过突出骨科医疗服务获取和利用方面的差异,可为半月板损伤的公平治疗策略提供参考。