种族,民族,语言,以及对低风险发烧婴儿的治疗
Colleen K Gutman1,2, Paul L Aronson3,4, Nidhi V Singh5
1Department of Emergency Medicine, University of Florida College of Medicine, Gainesville.
JAMA pediatrics
|November 13, 2023
概括
语言障碍,而不是种族或种族,与发烧的婴儿不必要的干预有关. 解决沟通缺口对于儿童急诊医学中的公平护理至关重要.
科学领域:
- 儿科急救医学 儿科急救医学
- 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:
- 患有侵袭性细菌感染风险较低的发烧婴儿通常会接受不必要的腰部刺穿,抗生素或住院治疗.
- 现有研究尚未澄清种族,族裔或语言是否影响这些管理决策.
研究的目的:
- 检查种族,族裔,语言之间的关联,以及使用腰部穿刺,经验性抗生素和在看起来健康,低风险的发烧婴儿住院的情况.
- 根据人口因素,确定发烧婴儿管理中的潜在差异.
主要方法:
- 在2018年至2019年期间,使用儿科急诊室数据进行了多中心,回顾性,横截面分析.
- 包括4042名看起来健康的发烧婴儿 (29-60天),根据血液和尿液检测被认为是低风险的.
- 使用后勤回归模型来评估婴儿种族/种族,语言和接受干预措施之间的关联.
主要成果:
- 种族和种族与接受至少一个非指示干预措施的复合结果没有显著关联.
- 来自使用非英语语言家庭的婴儿至少接受一次非指示干预的几率更高 (aOR,1.16).
- 西班牙裔婴儿住院几率较低,而使用非英语语言的婴儿住院几率更高.
结论:
- 用于医疗护理的语言,而不是种族或种族,与在低风险发烧的婴儿中使用未指示的干预措施有关.
- 研究结果强调了种族,种族,语言和健康不平等的复杂相互作用.
- 未来的指导方针必须优先考虑以患者为中心的沟通,并解决与语言障碍相关的潜在差异,以确保公平的护理.
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