当前位置： SCI文献检索 > International Forum of Allergy & Rhinology期刊下所有文献 > Socioeconomic status impacts postoperative productivity loss and health utility changes in refractory chronic rhinosinusitis.

Socioeconomic status impacts postoperative productivity loss and health utility changes in refractory chronic rhinosinusitis.

Abstract：

BACKGROUND:Social determinants of health can have a substantial impact on treatment outcomes. Prior study has shown that socioeconomic status influences the likelihood of improvement in quality-of-life (QOL) following endoscopic sinus surgery (ESS). However, the impact of socioeconomic factors on changes in productivity loss and health utility after ESS remains unknown. METHODS:Adult patients (≥18 years of age) with chronic rhinosinusitis (CRS) who underwent ESS were prospectively enrolled into a multi-institutional cohort study. Productivity losses were calculated using the human capital approach and monetized using U.S. government-estimated wage rates. Health utility values (HUVs) were derived from the Medical Outcomes Study Short-Form-12 survey using University of Sheffield algorithms. Independent socioeconomic factors of interest included: age, gender, ethnicity, insurance status, educational attainment, and household income categorized via the Thompson-Hickey model. RESULTS:A total of 229 patients met inclusion criteria, and 163 (71%) provided postoperative follow-up. All subjects reported significant, within-subject improvement in both mean monetized productivity loss (p < 0.001) and HUV postoperatively (p < 0.001). Using paired sample statistics, patients with lowest income (≤$25,000/year) and with Medicare insurance did not report significant improvement in productivity loss (p ≥ 0.112) or HUV (p ≥ 0.081), although sample size limitations may have contributed to this finding. Patients in higher income tiers ($25,001 to $100,000/year and $100,001+/year) and those with employer-provided/private health insurance reported significant postoperative improvements in productivity loss and HUV (all p ≤ 0.003). CONCLUSION:Socioeconomic factors, including income and insurance provision, may impact improvements in productivity loss and HUV following ESS. Further research to validate these findings, ascertain mechanisms behind these results, and improve these outcomes is warranted.

journal_name

Int Forum Allergy Rhinol

journal_title

International forum of allergy & rhinology

authors

Beswick DM,Mace JC,Soler ZM,Rudmik L,Alt JA,Smith KA,Detwiller KY,Ramakrishnan VR,Smith TL

doi

10.1002/alr.22374

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1000-1009

issue

eissn

2042-6976

issn

2042-6984

journal_volume

pub_type

杂志文章,多中心研究

在线工具

Socioeconomic status impacts postoperative productivity loss and health utility changes in refractory chronic rhinosinusitis.