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社会経済的な地位と,標準以下の医療のリスク
H R Burstin1, S R Lipsitz, T A Brennan
1Division of General Medicine, Brigham and Women's Hospital, Boston, MA 02115.
JAMA
|November 4, 1992
まとめ
保険のない患者は,標準的なケアを受けていないため,医療上の怪我のリスクが高くなります. この研究は,保険状態に関連した患者の安全性の格差を強調し,公平な医療の必要性を強調しています.
科学分野:
- 医療サービス 研究 医療サービス
- 患者の安全性についてです.
- 健康の社会経済的決定要因
背景:
- 医療上の怪我は,医療における重要な懸念事項である.
- 社会経済的地位は,患者の有害事象のリスクに影響を与える可能性があります.
- これらの格差を理解することは,医療の質を向上させるために極めて重要です.
研究 の 目的:
- 患者の社会経済的状態が,医療上の怪我のリスクと相関するかどうかを判断する.
- 医療上の傷害の比率を評価する.
- リスクの増加に関連する特定の社会経済的要因を特定する.
主な方法:
- 1984年にニューヨークの51の病院から30,195の医療記録を分析した.
- 保険ステータス,人種,性別,所得を含む社会経済的パラメータの多変数分析.
- 患者特有のリスクを隔離するために,病院レベルの要因の制御.
主要な成果:
- 保険のない患者は,標準以下のケアを受けるリスクが2.35倍も高いことを示した.
- 人種,性別,または収入と医学的怪我のリスクとの間には独立した関連性が見つかりませんでした.
- 病院の特徴は,保険のない患者の観察されたリスクを変更しませんでした.
結論:
- 保険のない人口は,標準的なケアを受けていないため,医療上の怪我を起こすリスクが著しく高い.
- 調査結果は,医療制度内で保険のない患者の脆弱性を強調しています.
- 保険の状況に対処することは,医療上の誤りを軽減し,患者の安全性を改善するために非常に重要です.
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