在退伍军人事务医疗保健系统住院的男性死亡率中的种族差异
A K Jha1, M G Shlipak, W Hosmer
1General Internal Medicine Section (111A1), Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121, USA. ashishkjha@yahoo.com
JAMA
|February 15, 2001
概括
进入退伍军人事务 (VA) 医院的黑人患者的死亡率低于白人患者. 在VA系统中,这种生存优势可能反映了平等获得医疗保健和优质住院治疗的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 临床结果 临床结果
背景情况:
- 医疗保健结果中的种族差异往往与获得医疗保健的不平等联系在一起.
- 很少有研究在平等准入制度中调查了健康结果的种族差异.
研究的目的:
- 检查退伍军人事务 (VA) 医疗保健系统中患者死亡率的种族差异.
- 评估平等准入制度是否能缓解患者治疗结果中的种族差异.
主要方法:
- 一项队列研究分析了28,934名白人和7,575名黑人男性患者,这些患者被录取到147家VA医院.
- 在1995年10月至1996年9月期间,患者因6种常见的医学诊断而入院.
- 主要结局是30天死亡率;次要结局包括住院和6个月死亡率.
主要成果:
- 与白人患者 (5.8%) 相比,黑人患者 (4.5%) 的30天总死亡率较低 (RR,0.77;P =.001).
- 在所有6种诊断中,黑人患者的死亡率较低,即使在多变量调整后 (RR,0.75;P<.001).
- 在黑人患者中也观察到更低的调整后住院和6个月死亡率.
结论:
- 进入VA医院的黑人患者的死亡率低于白人患者.
- 观察到的黑人患者的生存优势需要进一步调查.
- 这些发现表明,平等获得医疗保健和高质量的住院护理在减少种族结果差异方面具有潜在的好处.
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