歧视性医疗保健经验和对严重疾病患者的医疗不信任
Crystal E Brown1, Sandra Y Jackson2, Arisa R Marshall3
1Cambia Palliative Care Center of Excellence at UW Medicine (C.E.B., A.R.M.), Seattle, Washington, USA; Division of Pulmonary, Critical Care, and Sleep Medicine (C.E.B.), Department of Medicine, University of Washington, Seattle, Washington, USA; Department of Bioethics and Humanities (C.E.B.), School of Medicine, University of Washington, Seattle, Washington, USA.
来自种族少数群体的患有严重疾病的患者报告了更多的歧视和对医疗保健的不信任. 解决这些差异需要有种族意识的战略来改善对边缘化人口的照顾.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 患者体验 患者体验
背景情况:
- 医疗保健中的歧视是一个公认的问题,但对其对患有严重疾病的患者的影响知之甚少.
- 了解患者报告的歧视经历对于改善医疗保健公平至关重要.
研究的目的:
- 确定严重疾病患者在医疗保健歧视经历中的种族差异.
- 调查这些歧视性经历与医疗不信任之间的联系.
主要方法:
- 调查使用医疗环境中的歧视 (DMS) 和医疗保健环境中的微攻击 (MHCS) 尺度来评估歧视.
- 基于集团的医疗不信任度 (GBMM) 尺度衡量了不信任.
- 回归模型分析了种族,社会经济因素之间的关联,并报告了歧视和不信任.
主要成果:
- 严重疾病的种族少数群体患者报告了更高的歧视和微型攻击率.
- 虽然歧视分数 (DMS) 与社会经济阶级有关,但黑人,美国原住民/阿拉斯加原住民和多种族人士的微型攻击分数 (MHCS) 较高.
- 尽管收入与不信任的关联较低,但黑人和美洲原住民/阿拉斯加原住民参与者报告总体不信任度较高.
结论:
- 歧视经历与医疗不信任的增加相关,特别是在黑人和美国原住民/阿拉斯加原住民严重疾病患者中.
- 有意识的种族干预是必要的,以打击对边缘患者群体的歧视和不信任.
- 解决这些系统性问题对于改善医疗保健结果和患者与提供者关系至关重要.
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