Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases.
Autor: | Tesch F; Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany. falko.tesch@ukdd.de., Schmitt J; Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany., Dröge P; Allgemeine Ortskrankenkasse (AOK) Research Institute, Berlin, Germany., Günster C; Allgemeine Ortskrankenkasse (AOK) Research Institute, Berlin, Germany., Seidler A; Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany., Flechtenmacher J; German Professional Association for Orthopedics and Trauma Surgery, Berlin, Germany., Lembeck B; German Professional Association for Orthopedics and Trauma Surgery, Berlin, Germany., Kladny B; Department of Orthopedics and Trauma Surgery, m&i Fachklinik Herzogenaurach, Herzogenaurach, Germany., Wirtz DC; Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany., Niethard FU; German Professional Association for Orthopedics and Trauma Surgery, Berlin, Germany., Lange T; Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany. |
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Jazyk: | angličtina |
Zdroj: | BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2023 Oct 02; Vol. 24 (1), pp. 774. Date of Electronic Publication: 2023 Oct 02. |
DOI: | 10.1186/s12891-023-06909-6 |
Abstrakt: | Background: A different utilization of health care services due to socioeconomic status on the same health plan contradicts the principle of equal treatment. We investigated the presence and magnitude of socioeconomic differences in utilization of diagnostic imaging and non-pharmaceutical conservative therapies for patients with spinal diseases. Methods: The cohort study based on routine healthcare data from Germany with 11.7 million patient-years between 2012 and 2016 for patients with physician-confirmed spinal diseases (ICD-10: M40-M54), occupation and age 20 to 64 years. A Poisson model estimated the effects of the socioeconomic status (school education, professional education and occupational position) for the risk ratio of receiving diagnostic imaging (radiography, computed tomography, magnetic resonance imaging) and non-pharmaceutical conservative therapies (physical therapy including exercise therapy, manual therapy and massage, spinal manipulative therapy, acupuncture). Results: Patients received diagnostic imaging in 26%, physical therapy in 32%, spinal manipulative therapy in 25%, and acupuncture in 4% of all patient-years. Similar to previous survey-based studies higher rates of utilization were associated with higher socioeconomic status. These differences were most pronounced for manual therapy, exercise therapy, and magnetic resonance imaging. Conclusions: The observed differences in health care utilization were highly related to socioeconomic status. Socioeconomic differences were higher for more expensive health services. Further research is necessary to identify barriers to equitable access to health services and to take appropriate action to decrease existing social disparities. (© 2023. BioMed Central Ltd., part of Springer Nature.) |
Databáze: | MEDLINE |
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