在接受复杂手术的患者中, postoperative 后果中的种族差异的调解者
Zorays Moazzam1, Selamawit Woldesenbet1, Muhammad Musaab Munir1
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
American journal of surgery
|September 24, 2023
概括
复杂手术结果的种族差异仍然存在,黑人患者不太可能达到教科书的结果. 结构性种族主义,包括住宅隔离和并发性疾病负担,对这些不平等有很大的贡献.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康 公平 卫生 公平
背景情况:
- 在医疗保健中的种族差异是一个重大问题.
- 了解种族对手术结果的直接和间接影响至关重要.
研究的目的:
- 量化种族对复杂手术后术后结果的直接和间接影响.
- 确定导致手术结果种族差异的因素.
主要方法:
- 在2014-2018年期间,对接受复杂手术 (AAA修复,CABG,肺切除,大肠切除) 的医疗保险患者的分析.
- 利用通用结构方程建模来评估种族对教科书结果 (TO) 的影响.
主要成果:
- 在930,033名患者中,46.8%实现了TO;黑人患者的几率较低 (OR 0.72).
- 种族直接解释了32.3%的TO差距.
- 住宅隔离 (39.4%) 和并发症负担 (21.0%) 是关键的间接因素.
结论:
- 与种族相关的医疗保健差异需要有针对性的政策干预.
- 解决结构性种族主义对于实现更公平的医疗保健系统至关重要.
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