探究根源:检查家庭卫生机构内部和家庭卫生机构之间在功能改进方面的不平等
Shekinah A Fashaw-Walters1, Momotazur Rahman2,3, Olga F Jarrín4
1Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Health services research
|June 25, 2023
概括
家庭健康功能改善中的种族和种族差异主要是由于机构之间的差异,而收入差异在机构内部仍然存在. 需要文化敏感的干预措施来解决这些不平等问题.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 老年学是一门学科.
背景情况:
- 家庭卫生机构 (HHA) 在患者康复和功能改善方面发挥着至关重要的作用.
- 现有的研究表明,基于种族,种族和收入,医疗保健获得和结果存在差异.
- 了解HHA内部的这些差异对于改善公平的护理服务至关重要.
研究的目的:
- 量化家庭保健患者在功能改善中的种族,种族和基于收入的差异.
- 区分发生在家庭卫生机构内部与家庭卫生机构之间的差异.
主要方法:
- 利用了2016-2017年医疗保险数据,包括结果和评估信息集和人口普查数据.
- 雇佣的多项-logit分析,有和没有家庭卫生机构固定效应.
- 通过使用预测边际,根据种族,种族和收入计算功能改善的调整后果率.
主要成果:
- 与白人和高收入患者相比,黑人,西班牙裔,美洲印第安人/阿拉斯加土著 (AIAN) 和低收入患者的功能改善有显著差异.
- 在计算家庭卫生机构固定的影响时,种族和少数民族群体的差异在很大程度上得到了缓解,这表明机构之间的差异.
- 在家庭卫生机构内,基于收入的差异仍然存在,这表明机构内部的因素有很大贡献.
结论:
- 家庭卫生机构内部和家庭卫生机构之间的差异都会导致患者功能改善的差异.
- 解决这些不平等问题需要文化上适当的干预措施,并提高服务于边缘化人口的HHA的质量.
- 激励HHA内部的公平是改善患者结果和确保公平护理的关键.
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