000			03601nam a22004697a 4500
008			241030s20242024 xxu||||| |||| 00| 0 eng d
022			_a0039-6060
024			_aS0039-6060(24)00449-5 [pii]
040			_aOvid MEDLINE(R)
099			_a39048331
245			_aUnderstanding delays to parathyroidectomy: A mixed-methods approach.
251			_aSurgery. 2024 Jul 23
252			_aSurgery. 2024 Jul 23
253			_aSurgery
260			_c2024
260			_fFY2025
260			_p2024 Jul 23
265			_saheadofprint
265			_tPublisher
266			_d2024-10-30
266			_z2024/07/24 21:52
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aBACKGROUND: Patients from ethnic and racial minority groups with primary hyperparathyroidism may have greater time delays to curative parathyroidectomy. Contributing factors are unclear.
520			_aCONCLUSION: Care delays are driven by a combination of socioeconomic and nonsocioeconomic factors. Copyright © 2024 Elsevier Inc. All rights reserved.
520			_aMETHODS: This was a sequential mixed-methods study. The quantitative phase was a retrospective chart review of adults with primary hyperparathyroidism who underwent parathyroidectomy between 2015 and 2020, collecting demographic and clinical data. Social vulnerability of the patients' residential area, measured with the Social Vulnerability Index, and relevant clinical time intervals were calculated. A multivariable analysis of factors associated with greater time intervals was performed. The qualitative phase involved semistructured interviews with endocrinologists, analyzed inductively for themes.
520			_aRESULTS: On chart review of 1,083 patients, the median age was determined to be 61 years and 856 (79%) were female. Six hundred twenty-eight (57.9%) were non-Hispanic White and 456 (42.1%) were Hispanic ethnicity or Asian, Pacific Islander, Black, Native American, Other or Unknown race. Patients of Hispanic ethnicity, or Asian or Pacific Islander, Black, Native American, Other or Unknown race were more likely than non-Hispanic White patients to live in the most socially vulnerable areas (19.3% vs 5.9%, P < .01) and had greater time intervals than non-Hispanic White patients between index hypercalcemia and first parathyroid hormone level, surgical referral, or parathyroidectomy (all P < .05). On multivariable analysis, age (coefficient 7.9, 95% CI 2.8-13.0) and living in the most socially vulnerable areas (coefficient 297.9, 95% CI 87-508.7) were associated with greater days between index hypercalcemia and parathyroidectomy. In the study's qualitative phase, identified themes for reasons for care delays included socioeconomic, nonsocioeconomic patient, and nonsocioeconomic nonpatient factors.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aSurgery/Endocrine Surgery
657			_aJournal Article
700			_aCarroll, Nancy M _bMWHC
700			_aFelger, Erin A _bMWHC
700			_aLai, Victoria _bMWHC
700			_aRosen, Jennifer E _bMWHC
700			_aSanghavi, Kavya _bMHRI
790			_aChen C, Li W, Sanghavi KK, Lu J, Wong G, Nijhar S, Snee I, McGowan T, Kim M, Dabbas MR, Li K, Felger EA, Carroll NM, Rosen JE, Lai V
856			_uhttps://dx.doi.org/10.1016/j.surg.2024.06.026 _zhttps://dx.doi.org/10.1016/j.surg.2024.06.026
942			_cART _dArticle
999			_c14713 _d14713