Description
- Abstract:
- Background: The timing of MRI ordering and completion has been used as a marker of timely diagnosis and treatment. While the causes of delays are likely multifactorial, a growing body of evidence is emerging suggesting a link between socioeconomic status and delays in care. While insurance status is a reasonable marker for socioeconomic status, a more comprehensive measure is the Social Deprivation Index (SDI), a composite measure of demographic characteristics collected in the American Community Survey. SDI is a validated, county-level, easily accessible measure of socioeconomic variation in health outcomes based on seven criteria: income, education, employment, housing, household characteristics, transportation, and demographics. The purpose of this project is to determine how socioeconomic factors affect the timing of orthopaedic care, elucidating the impacts of socioeconomic factors on care in the area, and aiding providers in mitigating the factors associated with delays in treatment. Methods: A retrospective chart review was completed of patients 21 years old and younger with a history of knee sports injury (ligamentous/soft tissue injury, structural abnormality, instability, inflammation) evaluated with MRI between 5/26/2017 and 12/28/2020. Patients were from three states and attended to by physicians associated with an urban academic institution. Patients were assigned SDI scores based on their ZIP code. Excluded from the study were patients with a non-knee related diagnosis (hip, foot, or ankle), patients from ZIP codes with unknown SDI, and non-sports medicine diagnoses (tumor, infection, fracture). Results: In a multivariate regression analysis of 355 patients, SDI was independently associated with increased time from clinic visit to MRI order (p = 0.044) and from clinic visit to MRI completion (p = 0.047). Each 10-point increase in SDI was associated with a delay of 7.2 days on average. SDI itself was found to be associated with a patient’s race (p < 0.001), ethnicity (p < 0.001), and insurance category (p < 0.001). Conclusion: Increased SDI is independently associated with longer time from clinic visit to knee MRI order and longer time from clinic visit to knee MRI completion in our pediatric population. Barriers to timely orthopaedic care should be recognized and efforts to address these barriers should be pursued.
- Notes:
- Scholarly concentration: Non-Scholarly Concentrator
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Citation
Nacier, Catherine M., Vustecu, Emil S., Orman, Sebastian, et al.,
"The Effect of Socioeconomic Factors on Delays in Obtaining Pediatric Knee MRIs"
(2022).
Warren Alpert Medical School Academic Symposium.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:zna767d9/
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Warren Alpert Medical School Academic Symposium
The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …...