在急诊部护理队列跳跃的社会人口统计差异
Rohit B Sangal1, Huifeng Su2, Hazar Khidir1,3
1Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.
JAMA network open
|July 28, 2023
概括
边缘化的人群在急诊室 (ED) 获得护理方面面临差异,更频繁地遇到无法解释的队列跳跃 (UQJ). 这导致走廊放置的次数增加,患者没有接受治疗就离开,凸显了对标准化ED分拣流程的需求.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 紧急诊所 (ED) 的分组旨在根据急性和到达时间对患者进行优先排序.
- 无法解释的队列跳跃 (UQJ) 违反了这些原则,可能导致护理获取差异.
研究的目的:
- 通过检查无法解释的队列跳跃 (UQJ) 来描述ED护理准入方面的差异.
- 评估UQJ与ED结局的关联,包括走廊安置和未经治疗离开的患者.
主要方法:
- 在两个地点对超过314,000名ED患者访问的回顾性,横截面研究.
- 定义UQJ为患者接受治疗之前更高的敏度或更早到达的患者相同的敏度.
- 使用回归模型分析UQJ,患者人口统计和ED结果之间的关联.
主要成果:
- 28.8%的患者经历了队列跳跃.
- 医疗补助保险,非西班牙裔黑人种族,西班牙裔/拉丁裔种族以及西班牙语作为主要语言与被忽视有关.
- 被同一个分拣级别的人抛弃的患者,在走廊放置和在处置前离开的几率更高.
结论:
- 在获得ED护理方面存在显著的差异,边缘化人口更有可能经历UQJ.
- UQJ与负面的ED结果有关,包括走廊放置和没有治疗的患者离开.
- 标准化ED分拣过程对于减轻偏见和确保公平的护理准入至关重要.
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