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- Talk
- 15/06/2021
- Canada
Social Determinants of Health in Orthopaedics: An Assessment of Fracture Patients’ Non-Fracture Needs: A Pilot Study
Description
The presentation features Ian Laxdal, a PGY4 resident at the University of Manitoba, discussing his research on the Social Determinants of Health in Orthopedics, particularly focusing on an assessment of fracture patients' non-fracture needs. This pilot study was prompted by the World Health Organization's identification of social determinants of health in 1998, including income, education, and access to health services, which significantly impact patient outcomes. Despite effective treatment, some fracture patients still experience poor outcomes, indicating that external factors may play a crucial role.
Ian introduces a novel non-fracture needs (NFN) survey tool developed by an interdisciplinary focus group consisting of orthopedic surgeons, social workers, and sociologists. The survey, which includes 42 questions based on established tools and social determinants of health, incorporates dimensions of deprivation, such as material and social relationships. Initially, patients aged 17 to 65 were approached at their first fracture clinic follow-up to complete the NFN tool along with the EQ-5D assessment, measuring their quality of life before and six months after their injury.
The study profile highlights that 69 patients were approached, with 44 successfully completing the survey. The demographics revealed a balanced gender ratio with an average age of 44. Notably, multivariate regression analysis identified six questions as predictive of poor outcomes, linking themes of financial constraints, low social support, and transportation issues to decreased quality of life post-injury.
The findings underscore multiple social determinants impacting fracture patients and offer a framework for clinical interventions. Moving forward, Ian plans to expand the survey's application to a larger group of 180 patients to refine the tool and confirm the significant predictors of outcomes, ultimately aiding in the identification of additional patient needs and facilitating referrals to social workers. The presentation concludes with acknowledgments and a commitment to ongoing research.