在急性住院患者康复中识别种族和民族差异
Amanda A Herrmann1, Bo B Podgorski2, Sarah J Hatton2
1HealthPartners Institute, Minneapolis, MN; HealthPartners Neuroscience Center, St. Paul, MN.
Archives of physical medicine and rehabilitation
|March 4, 2024
概括
非白人和英语水平有限的患者的功能恢复较差,住院康复设施 (IRF) 的出院目的地不同. 这些种族和语言差异凸显了持续的医疗保健不平等.
科学领域:
- 康复医学 康复医学 康复医学
- 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:
- 种族,民族和语言少数群体经常面临医疗保健差异.
- 住院康复设施 (IRF) 在患者康复和出院计划中发挥着至关重要的作用.
研究的目的:
- 调查急性住院康复设施 (IRF) 中患者在功能恢复和出院目的地的种族,种族和语言差异.
- 根据种族,族裔和语言能力,检查功能独立度 (FIM) 评分和出院处分的变化.
主要方法:
- 从2013年至2019年期间入院于城市IRF的2518名患者的回顾性分析.
- 在种族,种族和语言群体之间比较FIM分数和排放目的地,并进行共变量调整.
- 根据保险类型和诊断 (中风与非中风) 分析子组内的差异.
主要成果:
- 非白人患者和英语水平有限的患者的功能恢复明显较低 (FIM分数变化较小).
- 与白人和说英语的患者相比,这些群体更有可能在家庭医疗保健和熟练护理机构的家庭医疗保健中出院.
- 医疗补助/医疗保险和中风诊断的患者的出院目的地的差异仍然存在,但对于那些有商业保险或非中风诊断的患者而言,情况并非如此.
结论:
- 功能性恢复和排放目的地的种族和语言差异在CARF认证的IRF中被确定.
- 这些发现强调了需要有针对性的干预措施,以减少康复中的医疗保健不平等.
- 进一步的研究将侧重于制定和实施减轻所发现差异的战略.
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