流感疫苗接种中的种族差异:管理护理是否缩小了非洲裔美国人和白人之间的差距?
E C Schneider1, P D Cleary, A M Zaslavsky
1Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave, Fourth Floor, Boston, MA 02115, USA. eschneid@hsph.harvard.edu
JAMA
|September 27, 2001
概括
管理护理计划增加了所有人的流感疫苗接种率,但并没有减少疫苗接种方面的种族差异. 需要进一步的干预措施来解决预防性护理中的这些不平等问题.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 预防医学 预防医学
- 健康差异 在健康上的差异
背景情况:
- 在医疗保健服务利用方面,种族差异仍然存在.
- 管理护理对预防服务中的种族差异的影响仍然不清楚.
研究的目的:
- 为了比较管理护理和服务费保险模式之间的流感疫苗接种率的种族差异程度.
- 确定管理护理是否减少了流感疫苗接种中的种族差异.
主要方法:
- 1996年医疗保险当前受益者调查的分析.
- 包括13,674名非洲裔美国人和白人医疗保险受益者.
- 调整后的流感疫苗接种率和管理护理和服务费入学者之间的种族差异的比较.
主要成果:
- 与收费服务 (65.4%) 相比,管理护理入学者的流感疫苗接种率更高 (71.2%) .
- 虽然管理护理显示出较小的调整后种族差异趋势 (18.6%) 与收费服务 (24.9%),但这种差异在统计学上并不显著.
- 这两种保险类型在疫苗接种方面都呈现出统计学上显著的种族差异.
结论:
- 管理护理与两种种族群体流感疫苗接种率的增加有关.
- 管理护理并不能显著减少流感疫苗接种中的种族差异.
- 需要有针对性的战略来消除预防性服务采用的种族不平等.
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