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Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures

BACKGROUND: Socio-demographic factors have been suggested to contribute to differences in healthcare utilization for several elective orthopedic procedures. Reports on disparities in utilization of orthopedic trauma procedures remain limited. The purpose of our study is to assess the roles of clinic...

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Autores principales: Zelle, Boris A., Morton-Gonzaba, Nicolas A., Adcock, Christopher F., Lacci, John V., Dang, Khang H., Seifi, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852936/
https://www.ncbi.nlm.nih.gov/pubmed/31718674
http://dx.doi.org/10.1186/s13018-019-1402-8
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author Zelle, Boris A.
Morton-Gonzaba, Nicolas A.
Adcock, Christopher F.
Lacci, John V.
Dang, Khang H.
Seifi, Ali
author_facet Zelle, Boris A.
Morton-Gonzaba, Nicolas A.
Adcock, Christopher F.
Lacci, John V.
Dang, Khang H.
Seifi, Ali
author_sort Zelle, Boris A.
collection PubMed
description BACKGROUND: Socio-demographic factors have been suggested to contribute to differences in healthcare utilization for several elective orthopedic procedures. Reports on disparities in utilization of orthopedic trauma procedures remain limited. The purpose of our study is to assess the roles of clinical and socio-demographic variables in utilization of operative fixation of calcaneus fractures in the USA. METHODS: The National Inpatient Sample (NIS) dataset was used to analyze all patients from 2005 to 2014 with closed calcaneal fractures. Multivariate logistic regression analyses were performed to evaluate the impact of clinical and socio-demographic variables on the utilization of surgical versus non-surgical treatment. RESULTS: A total of 17,156 patients with closed calcaneus fractures were identified. Operative treatment was rendered in 7039 patients (41.03%). A multivariate logistic regression demonstrated multiple clinical and socio-demographic factors to significantly influence the utilization of surgical treatment including age, gender, insurance status, race/ethnicity, income, diabetes, peripheral vascular disease, psychosis, drug abuse, and alcohol abuse (p <  0.05). In addition, hospital size and hospital type (teaching versus non-teaching) showed a statistically significant difference (p <  0.05). CONCLUSIONS: Besides different clinical variables, we identified several socio-demographic factors influencing the utilization of surgical treatment of calcaneus fractures in the US patient population. Further studies need to identify the specific patient-related, provider-related, and system-related factors leading to these disparities.
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spelling pubmed-68529362019-11-20 Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures Zelle, Boris A. Morton-Gonzaba, Nicolas A. Adcock, Christopher F. Lacci, John V. Dang, Khang H. Seifi, Ali J Orthop Surg Res Research Article BACKGROUND: Socio-demographic factors have been suggested to contribute to differences in healthcare utilization for several elective orthopedic procedures. Reports on disparities in utilization of orthopedic trauma procedures remain limited. The purpose of our study is to assess the roles of clinical and socio-demographic variables in utilization of operative fixation of calcaneus fractures in the USA. METHODS: The National Inpatient Sample (NIS) dataset was used to analyze all patients from 2005 to 2014 with closed calcaneal fractures. Multivariate logistic regression analyses were performed to evaluate the impact of clinical and socio-demographic variables on the utilization of surgical versus non-surgical treatment. RESULTS: A total of 17,156 patients with closed calcaneus fractures were identified. Operative treatment was rendered in 7039 patients (41.03%). A multivariate logistic regression demonstrated multiple clinical and socio-demographic factors to significantly influence the utilization of surgical treatment including age, gender, insurance status, race/ethnicity, income, diabetes, peripheral vascular disease, psychosis, drug abuse, and alcohol abuse (p <  0.05). In addition, hospital size and hospital type (teaching versus non-teaching) showed a statistically significant difference (p <  0.05). CONCLUSIONS: Besides different clinical variables, we identified several socio-demographic factors influencing the utilization of surgical treatment of calcaneus fractures in the US patient population. Further studies need to identify the specific patient-related, provider-related, and system-related factors leading to these disparities. BioMed Central 2019-11-12 /pmc/articles/PMC6852936/ /pubmed/31718674 http://dx.doi.org/10.1186/s13018-019-1402-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zelle, Boris A.
Morton-Gonzaba, Nicolas A.
Adcock, Christopher F.
Lacci, John V.
Dang, Khang H.
Seifi, Ali
Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title_full Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title_fullStr Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title_full_unstemmed Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title_short Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures
title_sort healthcare disparities among orthopedic trauma patients in the usa: socio-demographic factors influence the management of calcaneus fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852936/
https://www.ncbi.nlm.nih.gov/pubmed/31718674
http://dx.doi.org/10.1186/s13018-019-1402-8
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