限定的英语水平和败血症 种族和种族的死亡率
Neha P Limaye1,2,3, Wilfredo R Matias4,5,6, Hallie Rozansky7,8,9
1Department of Medicine, Mount Sinai Hospital, New York, New York.
JAMA network open
|January 4, 2024
概括
有限的英语水平 (LEP) 并没有显著增加整体败血症死亡率. 然而,LEP与非西班牙裔白人患者的住院死亡率较高有关,这表明在护理中可能存在基于语言的不平等.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床结果 临床结果
- 健康 公平 卫生 公平
背景情况:
- 具有有限英语水平 (LEP) 的患者面临着重大的医疗保健障碍,可能导致更糟糕的健康结果.
- 败血症是美国死亡的主要原因,不成比例地影响弱势群体,但LEP对败血症结果的影响还未得到充分研究.
研究的目的:
- 调查有限英语水平 (LEP) 与败血症患者住院死亡率之间的关联.
- 为了确定LEP是否与败血症病例的死亡率增加有关.
主要方法:
- 对2709名在医院住院的败血症患者进行了回顾性队列研究,这些患者在第三级护理中心符合CDC标准 (2016-2019).
- 从电子医疗记录中收集的LEP数据;主要结果是住院患者的死亡率.
- 分析采用多变量概括估计方程模型,并进行倾向得分调整和协差分析.
主要成果:
- 总体而言,12.1%的患者患有LEP. 在LEP和英语熟练 (EP) 组之间,没有发现住院患者死亡率的显著差异 (OR,1.12).
- 亚组分析显示,非西班牙裔白人人口中LEP患者的住院死亡率明显更高 (调整后OR,1.56).
- 在种族和少数民族小组中,在LEP和EP患者之间没有观察到显著的死亡率差异.
结论:
- 在这个队列中,有限的英语水平 (LEP) 与整体败血症死亡率的增加无关.
- 特别是在非西班牙裔白人亚组中,观察到LEP和增加住院患者死亡率之间的显著关联.
- 研究结果表明,在败血症护理中存在潜在的基于语言的不平等,需要对其驱动因素进行进一步的研究,并为LEP患者开发公平护理模型.
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