紧急情况部门儿科准备和基于种族和种族的死亡率差异
Peter C Jenkins1, Amber Lin2, Stefanie G Ames3
1Department of Surgery, Indiana University School of Medicine, Indianapolis.
JAMA network open
|September 5, 2023
概括
具有更高准备分数的儿科急诊室可以提高生存率,但在急性医疗紧急情况中仍然存在种族差异. 提高准备能力减少了但没有消除这些差异,强调了需要综合健康公平战略的需要.
科学领域:
- 紧急医疗 紧急医疗
- 卫生公平性健康公平性
- 儿科重症监护 儿科重症监护
背景情况:
- 在急诊室 (ED) 的高儿科准备程度与儿童更好的存活率有关.
- 然而,提高ED儿科准备能力对种族和民族群体的公平利益仍然不清楚.
研究的目的:
- 评估ED儿科准备是否在不同儿科群体中公平地影响住院死亡率.
- 调查基于种族和种族的创伤儿童死亡率与急性医疗紧急情况之间的差异.
主要方法:
- 一项队列研究分析了来自11个州 (2012-2017) 的586个ED的数据,针对18岁以下的儿童.
- 住院死亡率是主要结局,与加权儿科准备率 (wPRS) 相比衡量.
- 多变量后勤回归分析了种族,种族,ED准备度和死亡率之间的关联.
主要成果:
- 患有急性医疗紧急情况的黑人儿童的死亡率高于其他群体 (OR, 1.69).
- 对于受创伤的儿童来说,死亡率没有显著的种族差异.
- 更高的ED儿科准备度 (最高四分位数) 与这两种疾病的死亡率显著降低有关.
结论:
- 儿童急性医疗紧急情况的死亡率存在种族差异,而不是创伤性伤害.
- 增加ED儿科准备能力减少了这些差异,但并没有消除它们.
- 将健康公平纳入儿科紧急护理计划至关重要,以解决持续存在的差异.
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