识别和缓解少数民族种族,民族和语言群体中中枢线相关的血液感染的差异
Caitlin L McGrath1,2, Brendan Bettinger3, Megan Stimpson3
1University of Washington, Seattle, Washington.
在儿科患者中发现了中央导管相关血流感染 (CLABSI) 的种族和语言差异. 质量改善举措显著降低了这些感染率,突出了针对性干预措施解决系统不平等问题的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 传染病流行病学 传染病流行病学
- 健康 公平 卫生 公平
背景情况:
- 由于种族主义和偏见导致的不公平护理在医疗保健中得到了记录.
- 这些差异对医疗相关感染 (HAI) 的影响不太清楚.
研究的目的:
- 确定来自少数种族,种族和语言群体的儿科患者中中央导管相关血流感染 (CLABSI) 率的差异.
- 评估旨在减少这些差异的质量改进 (QI) 计划的结果.
主要方法:
- 从2012年至2019年,对8269名带中央导管的儿科患者进行了回顾性队列研究.
- 分析患者的种族,种族和语言数据.
- 考克斯比例危险回归和中断时间序列分析,以评估差异和QI结果.
主要成果:
- 在黑人患者和英语水平有限 (LOE) 的患者中观察到更高的未调整的CLABSI率.
- 调整后的模型显示,黑人患者 (aHR,1.8) 和LOE患者 (aHR,1.6) 的CLABSI风险显著更高.
- 质量改善干预措施导致黑人患者和LOE患者的CLABSI率在统计学上显著降低.
结论:
- 在调整风险因素后,黑人和LOE儿科患者的CLABSI率差异仍然存在,这表明有系统的种族主义和偏见.
- 有针对性的质量改善干预措施有效地减少了与医疗保健相关的感染,并改善了公平.
- 在实施QI之前,分层分类结果以识别差异,这对于为目标干预提供信息至关重要.
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