Diagnostic opportunity for developing hip dysplasia: Difference between the contributory social security health system and the prepaid and private medical systems in Bogotá.
Keywords:
Hip dislocation, congenital, Osteotomy, methodsAbstract
Introduction: The goal of the study is to determine whether a difference exists in the timing for the diagnosis of developmental hip dysplasia (DHD) among patients belonging to the Colombian contributory social security system and patients from the private practice (prepaid medical insurances, companies and private patients).
Methods: This is a cross-sectional study of patients attending pediatric orthopedic outpatient clinic that were diagnosed with DHD. The data were collected from the Hospital Infantil de San José and from three private offices of three pediatric orthopedic surgeons in Bogotá. The prevalence of early diagnosis was assessed taking into account the patient's age at the time of the first X rays of the hips and the first pediatric orthopedic consultation.
Results: The data were compared and a big and statistically significant difference was found: 88.7 % of patients belonging to the Colombian contributory social security system had a late diagnosis versus 35 % of patients belonging to the private medicine. The risk of a late diagnosis was 14.6 times greater in patients from the Colombian security system compared with from the patients from the private practice (OR 14.6; 95 % CI 5.3 to 40.5).
Discussion: Based on published scientific evidence it can be considered that the patients from the Colombian security system with DDH are more prone to be late diagnosed and have a higher risky and more expensive treatments, as well as less successful and worse prognosis.
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