Abstract：
UNASSIGNED: Distal radius fractures account for nearly 25% of fractures in adults, with a trend toward operative fixation. The objective of this study was to assess the relationship between surgeon and hospital volume with complications following distal radius fixation.
UNASSIGNED: A retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009 to 2015. Outpatient claims were identified for distal radius fractures and surgery. The facility and surgeon\'s identifier were used to calculate annual procedure volume. The risk for infection, carpal tunnel surgery, and revision/hardware removal was analyzed, and Social Deprivation Index (SDI) was linked to each patient. Patient demographics and rate of complications were compared across hospital and physician volume.
UNASSIGNED: A total of 14 748 patients were included, finding Federal and self-pay insurance associated with low-volume (LV) facility care and private insurance with high-volume (HV) facilities. The SDI for patients treated by LV surgeons and hospitals was significantly higher compared with HV providers. Low-volume facilities and surgeons had a higher 3-month risk of infection requiring reoperation. High-volume facilities were less likely to treat Hispanic patients, those with comorbidities, higher SDI, and with Federal or self-pay insurance.
UNASSIGNED: Patients treated by LV surgeons and facilities had a higher risk of infection requiring surgery within 3 months than those treated by HV providers. Low-volume facilities were more likely to treat patients who were Hispanic, Federally insured, and with comorbidities and higher SDI than HV facilities, increasing their risk for disadvantaged care.
UNASSIGNED: Level III.
UNASSIGNED: A retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009 to 2015. Outpatient claims were identified for distal radius fractures and surgery. The facility and surgeon\'s identifier were used to calculate annual procedure volume. The risk for infection, carpal tunnel surgery, and revision/hardware removal was analyzed, and Social Deprivation Index (SDI) was linked to each patient. Patient demographics and rate of complications were compared across hospital and physician volume.
UNASSIGNED: A total of 14 748 patients were included, finding Federal and self-pay insurance associated with low-volume (LV) facility care and private insurance with high-volume (HV) facilities. The SDI for patients treated by LV surgeons and hospitals was significantly higher compared with HV providers. Low-volume facilities and surgeons had a higher 3-month risk of infection requiring reoperation. High-volume facilities were less likely to treat Hispanic patients, those with comorbidities, higher SDI, and with Federal or self-pay insurance.
UNASSIGNED: Patients treated by LV surgeons and facilities had a higher risk of infection requiring surgery within 3 months than those treated by HV providers. Low-volume facilities were more likely to treat patients who were Hispanic, Federally insured, and with comorbidities and higher SDI than HV facilities, increasing their risk for disadvantaged care.
UNASSIGNED: Level III.
摘要：
■桡骨远端骨折占成人骨折的近25%，具有手术固定的趋势。这项研究的目的是评估外科医生和医院容量与桡骨远端固定后并发症之间的关系。
■2009年至2015年，使用纽约全州计划与研究合作系统数据库进行了一项回顾性研究。确定了桡骨远端骨折和手术的门诊索赔。设施和外科医生的标识符用于计算年度手术量。感染的风险，腕管手术,并对修订/硬件删除进行了分析，社会剥夺指数（SDI）与每位患者相关。在医院和医师之间比较了患者的人口统计学和并发症发生率。
■共纳入14748名患者，寻找与低容量（LV）设施护理和高容量（HV）设施私人保险相关的联邦和自付保险。与HV提供者相比，LV外科医生和医院治疗的患者的SDI明显更高。低容量设施和外科医生有较高的3个月感染风险，需要再次手术。高容量的设施不太可能治疗西班牙裔患者，那些有合并症的人，更高的SDI，以及联邦或自付保险。
■接受LV外科医生和机构治疗的患者在3个月内需要手术的感染风险高于接受HV提供者治疗的患者。低容量设施更有可能治疗西班牙裔患者，联邦保险，具有合并症和比HV设施更高的SDI，增加他们对弱势护理的风险。
■三级。
■2009年至2015年，使用纽约全州计划与研究合作系统数据库进行了一项回顾性研究。确定了桡骨远端骨折和手术的门诊索赔。设施和外科医生的标识符用于计算年度手术量。感染的风险，腕管手术,并对修订/硬件删除进行了分析，社会剥夺指数（SDI）与每位患者相关。在医院和医师之间比较了患者的人口统计学和并发症发生率。
■共纳入14748名患者，寻找与低容量（LV）设施护理和高容量（HV）设施私人保险相关的联邦和自付保险。与HV提供者相比，LV外科医生和医院治疗的患者的SDI明显更高。低容量设施和外科医生有较高的3个月感染风险，需要再次手术。高容量的设施不太可能治疗西班牙裔患者，那些有合并症的人，更高的SDI，以及联邦或自付保险。
■接受LV外科医生和机构治疗的患者在3个月内需要手术的感染风险高于接受HV提供者治疗的患者。低容量设施更有可能治疗西班牙裔患者，联邦保险，具有合并症和比HV设施更高的SDI，增加他们对弱势护理的风险。
■三级。
