Access to laser therapy for treatment of hypertrophic scars after burn injury.

Abstract

Hypertrophic scarring, a frequent complication of burn injuries, leads to pain, functional impairment, and psychological distress. Laser therapy, particularly by means of a fractional ablative laser, has become a standard treatment to improve scar aesthetics and quality of life. Despite its adoption, disparities in access remain underexplored. This study utilized data from the State Ambulatory Surgery and Services Databases (2014-2019) for New York and Florida, identifying patients receiving laser therapy for hypertrophic scars. Comparative analyses included demographic and socioeconomic factors, assessed vis-à-vis a general burn admission cohort from the 2020 Healthcare Cost and Utilization Project National Inpatient Sample. Logistic regression evaluated predictors of laser therapy utilization while Poisson regression evaluated temporal trends. Among 709 laser therapy recipients, patients were significantly younger (β: -0.001; 95 % CI -0.001, -0.002), predominantly female (OR: 2.19; 95 % CI 1.87-2.56), and non-white (OR: 1.44; 95 % CI 1.23-1.69) compared to the general burn cohort. They also predominantly resided in higher-income zip codes (OR: 4.25; 95 % CI 3.26-5.66). While 37.5 % of all burn admissions are from the lowest income quartile, only 29.5 % of all laser cases were low income. In comparison, 24.5 % of all laser cases were in the highest income quartile compared to 14.7 % of all burn admissions. There was a significant increase in the incidence of laser treatments over the study period (IRR [95 %]: 1.29 [1.23-1.35]) CONCLUSION: Recipients of laser therapy for hypertrophic scars differ demographically from the United States inpatient burn population, highlighting disparities shaped by demographic and socioeconomic factors.