■健康差异的社会决定因素已被证明对桡骨远端骨折(DRF)治疗后的结果产生不利影响。从历史上看,确定DRF后医院使用增加的风险因素一直很困难;然而,骨科医生最关心的是改善预后和降低护理总成本。DRF之后社会剥夺的影响尚未得到充分调查。
■这是一项回顾性队列分析,分析了2005年至2020年间单一机构采用手术或非手术方式治疗DRF的经验。患者人口统计信息和医疗保健利用(医院再入院,急诊科[ED]访视,办公室访问,和电话使用)从治疗后90天内收集。记录了区域剥夺指数(ADI)的国家百分位数。根据患者的相对剥夺水平将患者分为三节,并对其结果进行了比较。次要分析包括根据治疗方式对患者进行分层,种族,合法的性行为。
■总共,包括2,149名患者。最少的,中间,最贫困的群体包括552、1067和530名患者,分别。再入院的危险因素包括较高的相对剥夺水平。确定为黑人或非裔美国人和非手术治疗是增加ED访视的危险因素。再入院率没有差异,ED探视,办公室探访,或根据剥夺水平观察到电话使用情况。
■社会剥夺程度较高,治疗方式,种族,法律上的性别差异可能会影响DRF治疗后医院资源的利用率。了解和确定更多资源利用的风险因素可以帮助减轻不当使用并降低医疗保健成本。我们希望利用这些发现来指导临床决策,教育患者群体,并优化DRF治疗后的结果。
■治疗III.
UNASSIGNED: Social determinants of health disparities have been shown to adversely impact outcomes following distal radius fracture (DRF) treatment. Identifying risk factors for increased hospital use following DRF has been historically difficult; however, it is of utmost concern to orthopedic surgeons to improve outcomes and decrease the total cost of care. The effect of social deprivation following DRF has yet to be fully investigated.
UNASSIGNED: This is a retrospective cohort analysis of a single institution\'s experience in treating DRF with either an operative or nonsurgical modality between 2005 and 2020. Patient demographic information and health care utilization (hospital readmission, emergency department [ED] visitation, office visits, and telephone use) were collected from within 90 days of treatment. Area Deprivation Index (ADI) national percentiles were recorded. Patients were stratified into terciles based on their relative level of deprivation, and their outcomes were compared. Secondary analyses included stratifying patients based on treatment modality, race, and legal sex.
UNASSIGNED: In total, 2,149 patients were included. The least, intermediate, and most deprived groups consisted of 552, 1,067, and 530 patients, respectively. Risk factors for hospital readmission included higher levels of relative deprivation. Identifying as Black or African American and nonsurgical management were risk factors for increased ED visitation. No differences in rate of hospital readmission, ED visitation, office visitation, or telephone use were seen based on deprivation level.
UNASSIGNED: High levels of social deprivation, treatment modality, race, and legal sex disparities may influence the amount of hospital resource utilization following DRF treatment. Understanding and identifying risk factors for greater resource utilization can help to mitigate inappropriate use and decrease health care costs. We hope to use these findings to guide clinical decision making, educate patient populations, and optimize outcomes following DRF treatment.
UNASSIGNED: Therapeutic III.