Differences in the course of rehabilitation and outcomes for publicly insured pediatric patients after anterior cruciate ligament reconstruction
Differences in the course of rehabilitation and outcomes for publicly insured pediatric patients after anterior cruciate ligament reconstruction
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DOI：
10.1016/j.ptsp.2022.09.002
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发表时间：
2022-09-26
影响因子：
2.4
通讯作者：
Saper, Michael
中科院分区：
文献类型：
--
作者：
Greenberg, Elliot;Butler, Lauren;Saper, Michael
目的：探讨保险类型对儿童和青少年前交叉韧带重建术后物理治疗（PT）使用和预后的影响。设计：多中心回顾性队列研究。方法：将PT访问和功能跳测试性能提取到共享数据库中。每周的平均PT访问次数进行了总体和时间段的评估。独立样本检验检验了保险对PT利用的影响，使用多变量逻辑回归评估了保险状态对通过单腿跳跃测试的几率的影响。结果：共纳入281例患者（15.7 +/- 1.9,42%为女性）。其中128人（45%）有公共保险。公共保险患者从手术到跳跃测试的延迟时间更长（8.3个月对7.7个月，p = 0.009），每周参加PT的次数总体减少（0.92对1.04,p = 0.005），大多数减少的频率发生在7-24周之间。保险状况对通过单腿跳测试的几率有显著影响（2.72;95%CI, 1.27-5.81）。结论：公共保险患者平均每周PT访问次数较低，从手术到跳跃测试的延迟时间较长，通过单腿跳跃距离测试的可能性低2.7倍。
Objective: Examine the effect of insurance type on physical therapy (PT) utilization and outcomes within pediatric and adolescent patients after anterior cruciate ligament reconstruction. Design: Multicenter retrospective cohort study. Methods: PT visits and functional hop test performance were extracted into a shared database. The average number of PT visits per week was assessed overall and by time period. Independent samples ttest examined the effect of insurance on PT utilization and the effect of insurance status on the odds of passing single-legged hop tests was assessed using multivariable logistic regression. Results: A total of 281 patients (15.7 +/- 1.9, 42% female) were included in this analysis. Of these, 128 (45%) had public insurance. Publicly insured patients experienced a longer delay from surgery to hop test (8.3vs7.7 months, p = 0.009), attended overall fewer PT visits per week (0.92vs1.04, p = 0.005), with most of the decreased frequency occurring between weeks 7-24. Insurance status had a significant effect on the odds of passing the single leg hop test (2.72; 95%CI, 1.27-5.81). Conclusion: Publicly insured patients average a lower number of weekly PT visits, experienced a longer delay from surgery to hop testing and were 2.7 times less likely to pass the single leg hop for distance test.