病院前での抑止と鎮静剤の使用における人種的および民族的格差
Thomas J McAdam1, Seth J Prins1, John R Pamplin1
1Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
American journal of preventive medicine
|August 26, 2025
まとめ
行動に関する健康上の緊急事態を経験する人種や民族のマイノリティは,緊急医療サービス (EMS) の臨床医によって身体的に拘束されるか鎮静される可能性が高い. これらの格差は,これらのグループの精神的結果を悪化させる可能性があります.
科学分野:
- 緊急医療
- 医療サービス研究
- 健康に関する公平性
背景:
- 緊急医療サービス (EMS) は,行動に関する健康上の緊急事態を頻繁に管理します.
- 病院前での身体拘束や鎮静剤の使用は 十分に記録されていません
- 制度的な人種差別や医療へのアクセス問題は 少数派集団のケアにおける格差を 引き起こす可能性があります
研究 の 目的:
- 人種/民族関係と 病院前での抑止/鎮静剤の使用の関連性を調べる.
- 重要な患者との接触の管理における 潜在的な格差を特定する.
主な方法:
- 2022年ESOデータコラボレーションからの約12,000,000のEMS遭遇の分析.
- 行動的健康上の緊急事態を患った15歳以上の患者を含む.
- 人種/民族による抑止および/または鎮静剤の使用に対する調整された確率比 (aOR) の推定.
主要な成果:
- 行動に関する健康問題では 7.1%が 抑止や鎮静によるものでした
- すべての少数派人種/民族集団は,非ヒスパニック系白人患者と比較して,身体的抑制の確率が増加しました.
- 黒人/アフリカ系アメリカン,ヒスパニック系アメリカン,インディアン/アラスカ系アメリカン患者には鎮静剤の投与率が高く,黒人/アフリカ系アメリカン患者にも同時に鎮静剤の投与率が高かった.
結論:
- 人種的・民族的マイノリティでは 病院前での抑止と鎮静剤の使用に 格差がある.
- これらの格差は,特に黒人/アフリカ系アメリカ人の患者にとって,精神科の結果に悪影響を及ぼす可能性があります.
- 行動に関する緊急医療の改善には システム上の不平等に対処することが重要です
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