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1.
J Interpers Violence ; : 886260519889934, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31789085

RESUMO

Human trafficking is associated with a profound burden of physical and psychological trauma. Survivors of trafficking interact with the health care system during and after their experiences of trafficking. Socioeconomic isolation, stigma, shame, guilt, fear of judgment, fear of retribution by traffickers, fear of law enforcement authorities, and other factors known to inhibit disclosure can exert a formative influence on survivors' health care experiences, health care access, and health services engagement. Using a mixed qualitative-quantitative social science research method, known as by-person factor analysis (or Q-methodology), the current analysis systematically examines the scope of trafficking survivors' health care experiences and perceptions of medical care, health care access behaviors, and degree of engagement with health services. Among 33 survivors of human trafficking surveyed, 21 met inclusion criteria for this analysis. Three distinct profiles of survivor health care experiences and health services engagement-Avoidant, Distrustful, and Constrained-are identified from the aggregate of survivors' perceptions of medical care. Although there are salient differences across the three survivor profiles, a feeling of disenfranchisement is a common thread and directly related to health care access behaviors and health services engagement. Understanding that the feeling of disenfranchisement functions as a filter through which trafficking survivors perceive and experience medical care can help health care professionals take appropriate countermeasures. Implications for improving health care access and engagement include the implementation of trauma-responsive, culturally sensitive, and survivor-centered care practices.

2.
Int J Equity Health ; 18(1): 188, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791346

RESUMO

BACKGROUND: The decline in global and between-country health inequality is a major challenge to overcome. However, few studies have systematically investigated the relationship between inequality of health stock and national wealth. From an economic perspective, health can be viewed as a durable capital stock that produces an output of healthy time. Therefore, in this paper, we focused on health capital to investigate the relationship between inequalities of national health and national wealth. METHODS: Based on health stock data from 1990 to 2015 for 140 countries, we estimated Gini coefficients of health stock to investigate associations with a well-known economic flow indicator, Gross Domestic Product (GDP), stock-based national wealth indicator, Inclusive Wealth Index (IWI), and firm-level net income. RESULTS: The estimated Gini coefficient of global health stock shows that health stock has experienced a global decline. The Gini coefficient for low-income countries (LICs) showed the fastest decline in health stock, dropping from 0.69 to 0.66 in 25 years. Next, rapid population growth and the rise in the youth share of the working-age population in LICs were most likely contributing factors to the decline in inequality. Most countries that experienced positive health stock growth also indicated a strong positive relationship with GDP and IWI. However, some countries showed a negative relationship with natural capital, which is a part of IWI. In addition, firm-level net income showed no obvious associations with health stock, GDP and IWI. CONCLUSIONS: We argue that a negative relationship between health stock and natural capital is a sign of unstable development because sustainable development involves maintaining not only GDP but also IWI, as it is a collective set of assets or wealth comprising human, produced and natural capital. Moreover, in our analysis of firm-level income data, we also discuss that income will be influenced by other factors, such as innovations, human resources, organization culture and strategy. Therefore, the paper concludes that health stock is a vital component in measuring health inequality and health-related Sustainable Development Goals (SDGs). Thus, IWI is more comprehensive in measuring national wealth and can complement GDP in measuring progress toward sustainable development.

4.
JNCI Cancer Spectr ; 3(4): pkz084, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31840133

RESUMO

Background: Ovarian cancer remains a leading cause of death from gynecological malignancies. Race, socioeconomic status (SES), and access to health care are important predictors of quality treatment and survival. We provide a systematic review and meta-analysis on the role of these predictors on disparities in ovarian cancer treatment and mortality. Methods: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, EMBASE, and Scopus for relevant articles published between January 2000 and March 2017. We selected studies published in the United States that evaluated the role of race, SES, or health-care access on disparities in ovarian cancer treatment or survival. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated for each outcome using a random-effects model. Results: A total of 41 studies met the inclusion criteria for systematic review. In meta-analysis, there was a 25% decrease (RR = 0.75, 95% CI = 0.66 to 0.84) in receipt of adherent ovarian cancer treatment and 18% increased risk (RR = 1.18, 95% CI = 1.11 to 1.26) of mortality for blacks compared to whites. Receipt of adherent ovarian cancer treatment was 15% lower (RR = 0.85, 95% CI = 0.77 to 0.94) in the lowest vs highest SES group and 30% lower (RR = 0.70, 95% CI = 0.58 to 0.85) among patients at lower vs higher hospital volumes. Conclusion: We found consistent and strong evidence for continued lack of quality ovarian cancer treatment and higher mortality among ovarian cancer patients who are black, are of low SES, and/or have poor access to care. Interventions focused on these groups targeting specific barriers to care are needed to reduce disparities in ovarian cancer treatment and mortality.

5.
Anticancer Res ; 39(12): 6877-6880, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810956

RESUMO

BACKGROUND/AIM: This study aimed to analyze associated factors of 30-day hospital readmission after surgery for melanoma. PATIENTS AND METHODS: We conducted a retrospective analysis of postoperative 30-day unplanned readmission in patients with melanoma in the National Cancer Database (NCDB). RESULTS: Higher odds of unplanned readmission were found in non-white patients compared to white, uninsured patients compared to those with private insurance, tumors with invasive behavior compared to in situ, presence of ulceration, American Joint Committee on Cancer stages greater than II, and location in the extremities. Lower odds of unplanned readmission were found in women living in areas where the percentage of adults who did not graduate from high school was below 13.0% with an annual income of $38,000 or more, who were treated in Academic/Research Programs or Integrated Network Cancer Programs. CONCLUSION: Non-white patients and low-income zip-codes were associated with unplanned readmission.


Assuntos
Melanoma/cirurgia , Readmissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Disparidades em Assistência à Saúde/etnologia , Humanos , Lactente , Recém-Nascido , Masculino , Melanoma/etnologia , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/etnologia , Adulto Jovem
6.
Global Health ; 15(1): 67, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31847863

RESUMO

BACKGROUND: Countries must be able to describe and monitor their populations health and well-being needs in an attempt to understand and address them. The Sustainable Development Goals (SDGs) have re-emphasized the need to invest in comprehensive health information systems to monitor progress towards health equity; however, knowledge on the capacity of health information systems to be able do this, particularly in low-income countries, remains very limited. As a case study, we aimed to evaluate the current capacity of the national health information systems in Mozambique, and the available indicators to monitor health inequalities, in line with SDG 3 (Good Health and Well Being for All at All Ages). METHODS: A data source mapping of the health information system in Mozambique was conducted. We followed the World Health Organization's methodology of assessing data sources to evaluate the information available for every equity stratifier using a three-point scale: 1 - information is available, 2 - need for more information, and 3 - an information gap. Also, for each indicator we estimated the national average inequality score. RESULTS: Eight data sources contain health information to measure and monitor progress towards health equity in line with the 27 SDG3 indicators. Seven indicators bear information with nationally funded data sources, ten with data sources externally funded, and ten indicators either lack information or it does not applicable for the matter of the study. None of the 27 indicators associated with SDG3 can be fully disaggregated by equity stratifiers; they either lack some information (15 indicators) or do not have information at all (nine indicators). The indicators that contain more information are related to maternal and child health. CONCLUSIONS: There are important information gaps in Mozambique's current national health information system which prevents it from being able to comprehensively measure and monitor health equity. Comprehensive national health information systems are an essential public health need. Significant policy and political challenges must also be addressed to ensure effective interventions and action towards health equity in the country.


Assuntos
Equidade em Saúde/organização & administração , Sistemas de Informação em Saúde , Indicadores Básicos de Saúde , Saúde Pública , Disparidades nos Níveis de Saúde , Humanos , Moçambique , Desenvolvimento Sustentável , Organização Mundial da Saúde
7.
Artigo em Inglês | MEDLINE | ID: mdl-31845286

RESUMO

OBJECTIVES: To examine disparities in use and access to different health care providers by community and individual race-ethnicity and to test provider supply as a potential mediator. DATA SOURCES: National secondary data from 2014 Medical Expenditure Panel Survey, 5-year estimates (2010-2014) from American Community Survey, and 2014 InfoUSA. STUDY DESIGN: Multiple logistic regression models examined the association of community and individual race-ethnicity with reported health care visits and access. Mediation analyses tested the role of provider supply. DATA EXTRACTION METHODS: Individual-level survey data were linked to race-ethnic composition and health business counts of the respondent's primary care service area (PCSA). PRINCIPAL FINDINGS: Minority PCSAs are significantly and independently associated with lower odds of having a visit to a physician assistant/nurse practitioner, dentist, or other health professionals and having a usual care provider (all p < 0.05). Few significant associations were observed for integrated PCSAs or for health provider supply. A modest mediation effect for provider supply was observed for travel time to usual care provider and visit to other health professionals. CONCLUSIONS: Use of a range of health services is lower in minority communities and individuals. However, provider supply was not an important explanatory factor of these disparities.

9.
Salud Publica Mex ; 61(6): 726-733, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31869537

RESUMO

OBJECTIVE: To estimate inequalities in access to health services among Mexican population living in localities of 100 000 or less inhabitants. MATERIALS AND METHODS: Cross-sectional analysis using the National Health and Nu- trition Survey 100k 2018 survey data. Access was estimated using health insurance and care for the last health condition. As inequality measure, we estimated the concentration index using an imputation of household per capita income. RESULTS: Among studied population, health insurance was 82.42% and access to care 60.03%. We identified inequalities in both indicators; marginal and pro-poor for insurance and pro-rich for access to care. CONCLUSIONS: In Mexico, even within the popuation living in poverty there are inequalities in access to health care. More granular public interventions are needed to address inequalities in an effective way.

10.
Artigo em Inglês | MEDLINE | ID: mdl-31873831

RESUMO

OBJECTIVE: Few population-based studies have examined the health care experiences of children with sexual minority parents. The purpose of this study was to compare health insurance status, access to care, and health services utilization for children by mother's sexual orientation. METHODS: We used data on children with lesbian mothers (n = 195), bisexual mothers (n = 299), and heterosexual mothers (n = 23,772) in the 2013-2017 National Health Interview Survey. Logistic regression models were used to compare health insurance status, access to care, and health services utilization while adjusting for demographic and socioeconomic characteristics of the child, mother, and household. RESULTS: After controlling for sociodemographic factors, there were no statistically significant differences in health insurance coverage, access to care, or health services utilization between children of lesbian mothers and children of heterosexual mothers. Compared to children with heterosexual mothers, children with bisexual mothers were more likely to have public health insurance (OR 2.33; 95% CI 1.07-7.68), delayed medical care due to cost (OR 2.33; 95% CI 1.12-4.86), unmet medical care due to cost (OR 2.86; 95% CI 1.07-7.68), and a visit to the emergency room (OR 1.74; 95% CI 1.27-2.39) in the prior year after controlling for child-level characteristics. Some of these differences were attenuated after controlling for maternal demographics and household characteristics. CONCLUSIONS FOR PRACTICE: Children with bisexual mothers experience barriers to routine medical care. Addressing socioeconomic dimensions of health care access and targeted outreach to bisexual parents will help promote health equity for children growing up in sexual minority households.

11.
Artigo em Inglês | MEDLINE | ID: mdl-31878112

RESUMO

The mortality-to-incidence ratio (MIR) is associated with the clinical outcomes of different types of cancer as well as the ranking of health care systems. However, the association between MIRs for testicular cancer and health care disparities, including differences in expenditures and health system rankings, has not yet been reported. We used the Spearman's rank correlation coefficient (CC) to analyze the correlation between testicular cancer MIRs and both total expenditures on health/gross domestic product (e/GDP) and the World Health Organization's (WHO) health system rankings. After screening the data for quality and missing information, 57 countries were chosen for analysis. Generally, developed countries and regions had relatively high rates of incidence/mortality, but with a favorable MIR. Among the continents, Europe had the highest incidence rates, whereas the highest MIRs were in Africa. Globally, favorable testicular cancer MIRs were observed in countries with both a high e/GDP and a good WHO ranking (R2 = 0.325, p < 0.001 and CC = -0.568, p < 0.001; R2 = 0.367, p < 0.001 and CC = 0.655, p < 0.001, respectively). In conclusion, the MIR for testicular cancer varies in countries and regions based on both their total health expenditure and their health care system ranking.

12.
RECIIS (Online) ; 13(4): 768-783, out.-dez. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1047541

RESUMO

Este artículo analiza el proceso alimentario y la alimentación infantil, concretamente la lactancia materna y ablactación, como vías para estudiar las desigualdades de género. El estudio se realizó entre familias zoques de un municipio con alta prevalencia de desnutrición infantil en el sureste de México. Se empleó el método etnográfico y las técnicas de la entrevista en profundidad y la observación participante para recuperar el punto de vista de los padres y las madres de 14 niños zoques. Los resultados demuestran que la desigualdad en el acceso a los alimentos que sufren las mujeres y las niñas y niños por razones económicas, culturales y de género, afecta su estado nutricional y tendrá repercusiones a largo plazo, por lo que es urgente crear programas o iniciativas con perspectiva de género que posibiliten que la sociedad zoque reconozca los derechos de las mujeres y éstas mejoren su estatus.


Este artigo analisa o processo alimentar e a nutrição infantil, especificamente amamentação e ablação, como formas de estudar as desigualdades de gênero. O estudo foi realizado entre famílias zoque em um município com alta prevalência de desnutrição infantil no sudeste do México. O método etnográfico e as técnicas da entrevista em profundidade e da observação participante foram utilizadas para recuperar o ponto de vista dos pais e mães de 14 crianças zoqueis. Os resultados mostram que a desigualdade no acesso à alimentação sofrida por mulheres, meninas e meninos por razões econômicas, culturais e de gênero afeta o estado nutricional e terá repercussões a longo prazo, por isso é urgente elaborar programas ou iniciativas com uma perspectiva de gênero que permite que a sociedade zoque reconheça os direitos das mulheres e melhore seu status.


This paper analyzes the food process and infant nutrition, specifically breastfeeding and ablactation, as ways to study gender inequalities. The study was conducted among zoque families in a municipality with a high prevalence of child malnutrition in southeastern Mexico. The ethnographic method and the techniques of the in-depth interview and the participant observation were used to recover the point of view of the fathers and mothers of 14 zoque children. The results show that inequality in access to food suffered by women and girls and boys for economic, cultural and gender reasons, affects their nutritional status and will have long-term repercussions, so it is urgent to design programs or initiatives with a gender perspective that allows zoque society to recognize women's rights and improve their status.


Assuntos
Humanos , Aleitamento Materno , Alimentação , Nutrição da Criança , México , Mulheres , Produção de Alimentos , Criança , Processo Saúde-Doença , Populações Vulneráveis , Agricultura , Antropologia Médica , Antropologia Cultural
13.
Urology ; 2019 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-31770548

RESUMO

For prostate cancer, we review racial differences in incidence, androgen pathways, growth factors, tumor location, rate of definitive treatment, and outcomes. We review the effect of race on risk-stratification and discuss studies of active surveillance in the African American population. For bladder cancer, race- and gender- associated differences in incidence, sex hormone pathways. For renal cell carcinoma, disparities in incidence, genetic factors, tumor pathology, time to presentation, and disease specific survival have been observed. We evaluate the impact of race and ethnicity on tumor pathology and discuss gaps in our current understanding of renal cell carcinoma pathogenesis.

14.
J Bone Joint Surg Am ; 101(22): e121, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31764373

RESUMO

The current health-care system in the United States has numerous barriers to quality, accessible, and affordable musculoskeletal care for multiple subgroups of our population. These hurdles include complex cultural, educational, and socioeconomic factors. Tertiary referral centers provide a disproportionately large amount of the care for the uninsured and underinsured members of our society. These gaps in access to care for certain subgroups lead to inappropriate emergency room usage, lengthy hospitalizations, increased administrative load, lost productivity, and avoidable complications and/or deaths, which all represent a needless burden on our health-care system. Through advocacy, policy changes, workforce diversification, and practice changes, orthopaedic surgeons have a responsibility to seek solutions to improve access to quality and affordable musculoskeletal care for the communities that they serve.

15.
J Forensic Nurs ; 15(4): 199-205, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31764523

RESUMO

Initial conceptualizations of violence and trauma in forensic nursing have remained relatively narrowly defined since the specialty's inception. The advent of trauma-informed care has been important but has limitations that obfuscate social and structural determinants of health, equity, and social justice. As forensic nursing practice becomes more complex, narrow definitions of violence and trauma limit the effectiveness of trauma-informed care in its current incarnation. In keeping with the nursing model of holistic care, we need ways to teach, practice, and conduct research that can accommodate these increasing levels of complexity, including expanding our conceptualizations of violence and trauma to advance health equity and social justice. The objective of this article is to introduce the concepts of structural violence and trauma- and violence-informed care as equity-oriented critical paradigms to embrace the increasing complexity and health inequities facing forensic nursing practice.


Assuntos
Enfermagem Forense , Equidade em Saúde , Trauma Psicológico/enfermagem , Justiça Social , Vítimas de Crime , Currículo , Educação em Enfermagem , Política de Saúde , Disparidades nos Níveis de Saúde , Humanos , Pesquisa em Enfermagem
17.
Nervenarzt ; 90(11): 1187-1200, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31667532

RESUMO

Social inequality refers to the inequitable distribution of social prosperity including the resource of health. The relationship between social inequality and mental health can be established by means of indicators of social inequality throughout all age groups in Germany. There are social gradients of mental health on the population level, i.e. the linear relationship between social classes or status and state of health. Fundamental determinants of health disparity are cultural, social, political, and geographical conditions, which interact with the genetic make-up and epigenetic processes. These determinants also influence the management of developmental tasks during the life course and are of utmost importance for the development of mental disorders. The maladaptation to chronic stress is at the core of health disparity. Interventions at the individual behavioral level should comprise the development of stress management and coping strategies.


Assuntos
Disparidades em Assistência à Saúde/etnologia , Transtornos Mentais , Serviços de Saúde Mental/estatística & dados numéricos , Saúde Mental , Alemanha , Humanos , Transtornos Mentais/etnologia , Classe Social , Fatores Socioeconômicos
18.
BMC Public Health ; 19(1): 1493, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703734

RESUMO

BACKGROUND: Antenatal care (ANC) services are critical for maternal health but Nigeria performs poorly in ANC utilisation compared to other countries in sub-Saharan Africa. This study aimed to assess socioeconomic inequalities in ANC utilisation and the determinants of these inequalities in Nigeria. METHODS: The 2013 Nigeria Demographic and Health Survey data with 18,559 women was used for analysis. The paper used concentration curves and indices for different measures of ANC utilisation (no ANC visit, 1-3 ANC visits, at least four ANC visits, and the number of ANC visits). A positive (or negative) concentration index means that the measure of ANC utilisation was concentrated on the richer (poorer) population compared to their poorer (richer) counterparts. The concentration indices were also decomposed using standard methodologies to examine the significant determinants of the socioeconomic inequalities in no ANC visit, at least four ANC visits, and the number of ANC visits. RESULTS: No ANC visit was disproportionately concentrated among the poor (concentration index (CI) = - 0.573), whereas at least four ANC visits (CI = 0.582) and a higher number of ANC visits (CI = 0.357) were disproportionately concentrated among the rich. While these results were consistent across all the geopolitical zones and rural and urban areas, the inequalities were more prevalent in the northern zones (which also have the highest incidence of poverty in the country) and the rural areas. The significant contributors to inequalities in ANC utilisation were the zone of residence, wealth, women's education (especially secondary) and employment, urban-rural residence, ethnicity, spousal education, and problems with obtaining permission to seek health care and distance to the clinic. CONCLUSIONS: Addressing wealth inequalities, enhancing literacy, employment and mitigating spatial impediments to health care use will reduce socioeconomic inequalities in ANC utilisation in Nigeria. These factors are the social determinants of health inequalities. Thus, a social determinants of health approach is needed to address socioeconomic inequalities in ANC coverage in Nigeria.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Grupos Étnicos , Feminino , Inquéritos Epidemiológicos , Humanos , Alfabetização , Nigéria , Gravidez , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
19.
BMC Public Health ; 19(1): 1513, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718594

RESUMO

BACKGROUND: Discrimination is a major driver of health disparities among minority groups and can impede the reach of public health programs. In the Dominican Republic, residents of bateyes, or agricultural 'company towns,' often face barriers to health care. This study examined the extent of perceived discrimination among batey populations and places the findings within the context of disease elimination efforts. METHODS: In March-April 2016, a stratified, multi-stage cluster survey that included the 9-item Everyday Discrimination Scale (EDS) was conducted among residents (n = 768) of bateyes across the Dominican Republic. Exploratory factor analysis, differential item functioning, and linear and logistic regression were used to assess associations between EDS scores, ethnic group status, reasons for discrimination, and healthcare-seeking behavior. RESULTS: Three ethnic groups were identified in the population: Haitian-born persons (42.5%), Dominican-born persons with Haitian descent (25.5%), and Dominican-born persons without Haitian descent (32.0%). Mean EDS scores (range 0-45) were highest among persons born in Haiti (18.2, 95% confidence interval [CI] = 16.4-20.1), followed by persons with Haitian descent (16.5, 95% CI = 14.9-18.0), and those without Haitian descent (13.3, 95% CI = 12.1-14.5). Higher EDS scores were significantly associated with Haitian birth (ß = 6.8, 95% CI = 4.2-9.4; p < 0.001) and Haitian descent (ß = 6.1, 95% CI = 3.2-9.0; p < 0.001). Most respondents (71.5%) had scores high enough to elicit reasons for their discrimination. Regardless of ethnic group, poverty was a common reason for discrimination, but Haitian-born and Haitian-descended people also attributed discrimination to their origin, documentation status, or skin color. EDS scores were not significantly associated with differences in reported care-seeking for recent fever (ß = 1.7, 95% CI = - 1.4-4.9; p = 0.278). CONCLUSION: Perceived discrimination is common among batey residents of all backgrounds but highest among Haitian-born people. Discrimination did not appear to be a primary barrier to care-seeking, suggesting other explanations for reduced care-seeking among Haitian populations. Public health community engagement strategies should avoid exacerbating stigma, build active participation in programs, and work towards community ownership of disease control and elimination goals.


Assuntos
Agricultura , Grupos Étnicos , Acesso aos Serviços de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Pobreza , Discriminação Social , Migrantes , Adolescente , Adulto , Idoso , Erradicação de Doenças , República Dominicana , Feminino , Haiti , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Saúde Pública , Características de Residência , Inquéritos e Questionários , Adulto Jovem
20.
J Orthop Surg Res ; 14(1): 359, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718674

RESUMO

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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