种族,民族,保险类型和产后永久避孕的联系
Brooke W Bullington1, Kristen A Berg, Emily S Miller
1Department of Epidemiology, Gillings School of Global Public Health, the Carolina Population Center, and the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the Center for Health Care Research & Policy, Population Health Research Institute, and the Department of Obstetrics and Gynecology, MetroHealth Medical System, Cleveland, Ohio; the Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island; the Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; and the Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, California.
在未经调整的模型中观察到产后永久避孕的种族差异. 在控制了各种因素后,这些差异不再显著,这表明其他变量是调解的.
科学领域:
- 生殖健康 生殖健康
- 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:
- 永久避孕是产后避孕的理想方法.
- 了解获得和实现永久避孕的差异对于生殖健康平等至关重要.
研究的目的:
- 评估种族,种族,保险类型和满足永久避孕要求之间的关联.
- 识别在获得产后永久避孕措施方面的潜在差异.
主要方法:
- 在美国四家医院分娩的2,945名患者的回顾性队列的二次分析.
- 修改后的Poisson模型被用来评估人口因素与永久避孕实现之间的关联.
- 调整了年龄,平价,妊娠年龄,分娩类型,保险和其他相关共变量.
主要成果:
- 永久避孕的总体满足率在出院前为58.2%,在6周内为59.3%,在1年内为65.4%.
- 与私人保险患者相比,医疗补助保险患者实现满足的可能性较低.
- 未经调整的模型显示了种族差异,非西班牙裔黑人患者要求满足的可能性较低;然而,这些关联在调整后消失了.
结论:
- 未经调整的分析显示,在实现永久避孕方面存在显著的种族差异.
- 在控制了个人和设施层面的因素之后,种族,种族,保险类型和满足之间的关联被消除了.
- 这些发现表明,社会经济和其他测量共变量可能在系统性种族主义和避孕保健之间的途径中起到调解作用.
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