米国 の 緊急 部 で 異常 な 子宮 出血 の 診断 評価
Wanyi Huang1, Xiaomei Ma2, Mitchell Clark1
1Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
まとめ
異常な子宮出血 (AUB) に関する緊急治療室の訪問は,診断評価における人種差異を示しています. 非ヒスパニックの黒人女性は非ヒスパニックの白人女性と比較して 超音波検査とフォローアップの勧告を少なく受けました
科学分野:
- 産婦人科
- 医療サービス研究
- 健康に関する公平性
背景:
- 異常な子宮出血 (AUB) は,緊急治療室 (ED) に提示される一般的な婦人科の苦情です.
- EDにおけるAUBの診断評価パターンは,特に潜在的な人種的および民族的格差に関してよく理解されていません.
研究 の 目的:
- 緊急治療室 (ED) の訪問中に異常な子宮出血 (AUB) の診断評価パターンを調べる.
- AUBの診断作業における潜在的な人種的および民族的違いを特定する.
主な方法:
- 2014年から2021年までの国立病院の病院内医療調査データ分析
- 妊娠に関連していないAUBのためにEDを提示する18歳以上の女性を含む.
- 多変数ロジスティック回帰モデルは,人種/民族と,超音波検査を受ける可能性や,フォローアップ診察への紹介の関連性を評価するために使用されました.
主要な成果:
- 非ヒスパニックの黒人患者は,非ヒスパニックの白人患者と比較して,超音波検査 (aOR=5. 8),またはフォローアップ (aOR=5. 54) を受ける可能性が低い.
- ヒスパニック系患者は,非ヒスパニック系白人患者と比較して,診断評価において有意な差異を示さなかった.
- 診断評価の低下に関連する要因には,閉経前期の年齢と都市圏外の場所が含まれていました. 医師の相談は超音波の可能性を高め,フォローアップの可能性を減少させました.
結論:
- EDにおける異常な子宮出血の診断は,人種や民族によって大きく異なります.
- これらの発見は,AUBの女性に対する緊急ケアにおける不平等に対処する必要性を強調しています.
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