■这项研究考察了历史重修对当代神经外科护理的持久影响,强调历史上被边缘化的社区需要公平的医疗保健。
■为了调查重新调整如何影响美国社区神经外科医生的分配和报销,分析对医疗保健准入的影响。
■使用医疗保险和医疗补助服务中心(CMS)国家档案的数据进行了一项观察性研究,房主贷款公司(HOLC)邻里等级,和人口统计数据来评估美国91个城市的神经外科代表,按HOLC等级分类(A,B,C,D)和高档化状态。
■在257个社区中,A级,B,C,D区占5.40%,18.80%,45.8%,和30.0%的样本,分别。A级,B,与D级社区相比,C社区的白人和亚裔居民较多,黑人居民较少(p<0.001)。HOLCA级(OR=4.37,95CI:2.08,9.16,p<0.001),B(OR=1.99,95CI:1.18,3.38,p=0.011),与D级社区相比,C(OR=2.37,95CI:1.57,3.59,p<0.001)社区与较高的神经外科医师代表性相关。报销差距也很明显:在HOLCD级社区执业的神经外科医生收到的报销额明显低于A级社区($109,163.77vs.$142,999.88,p<0.001),B级社区($109,163.77vs.$131,459.02,p<0.001),和C级社区($109,163.77vs.$129,070.733,p<0.001)。
■历史修订继续塑造获得高度专业化的医疗保健,如神经外科。解决这些差距的努力必须考虑历史背景,并努力实现更公平的获得专门护理的机会。
UNASSIGNED: This study examines the lasting impact of historical redlining on contemporary neurosurgical care access, highlighting the need for equitable healthcare in historically marginalized communities.
UNASSIGNED: To investigate how redlining affects neurosurgeon distribution and reimbursement in U.S. neighborhoods, analyzing implications for healthcare access.
UNASSIGNED: An observational study was conducted using data from the Center for Medicare and Medicaid Services (CMS) National File, Home Owner\'s Loan Corporation (HOLC) neighborhood grades, and demographic data to evaluate neurosurgical representation across 91 U.S. cities, categorized by HOLC Grades (A, B, C, D) and gentrification status.
UNASSIGNED: Of the 257 neighborhoods, Grade A, B, C, and D neighborhoods comprised 5.40%, 18.80%, 45.8%, and 30.0% of the sample, respectively. Grade A, B, and C neighborhoods had more White and Asian residents and less Black residents compared to Grade D neighborhoods (p < 0.001). HOLC Grade A (OR = 4.37, 95%CI: 2.08, 9.16, p < 0.001), B (OR = 1.99, 95%CI: 1.18, 3.38, p = 0.011), and C (OR = 2.37, 95%CI: 1.57, 3.59, p < 0.001) neighborhoods were associated with a higher representation of
neurosurgeons compared to Grade D neighborhoods. Reimbursement disparities were also apparent:
neurosurgeons practicing in HOLC Grade D neighborhoods received significantly lower reimbursements than those in Grade A neighborhoods ($109,163.77 vs. $142,999.88, p < 0.001), Grade B neighborhoods ($109,163.77 vs. $131,459.02, p < 0.001), and Grade C neighborhoods ($109,163.77 vs. $129,070.733, p < 0.001).
UNASSIGNED: Historical redlining continues to shape access to highly specialized healthcare such as neurosurgery. Efforts to address these disparities must consider historical context and strive to achieve more equitable access to specialized care.