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社会经济地位和低标准医疗护理的风险
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
概括
没有保险的患者面临更高的医疗伤害的风险,因为不符合标准的护理. 这项研究强调了与保险状况相关的患者安全差异,强调了公平医疗保健的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 患者安全 患者安全
- 健康的社会经济决定因素
背景情况:
- 医疗伤害是医疗保健中的一个重要问题.
- 社会经济地位可能会影响患者发生不良事件的风险.
- 了解这些差异对于改善医疗保健质量至关重要.
研究的目的:
- 确定患者的社会经济地位是否与医疗伤害的风险相关.
- 评估医疗伤害的比例,源于不合格的护理.
- 确定与风险增加相关的特定社会经济因素.
主要方法:
- 1984年分析了来自纽约51家医院的30,195份医疗记录.
- 对社会经济参数的多变量分析,包括保险状况,种族,性别和收入.
- 控制医院级因素以隔离患者特异性风险.
主要成果:
- 没有保险的患者显示,接受低标准护理的风险是2.35倍.
- 没有发现种族,性别或收入与医疗伤害风险之间的独立关联.
- 医院的特点没有改变未保险患者的观察到的风险.
结论:
- 没有保险的人群由于不合格的护理而面临更高的医疗伤害风险.
- 调查结果强调了医疗保健系统中没有保险的患者的脆弱性.
- 解决保险状况对于减轻医疗错误和提高患者安全至关重要.
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