协议化滥用查,以减少提供者偏见,并增加对潜在事件的捕获
Ashley Chan1, Mary D Feller1, Kaylin Dawson2
1School of Medicine, Albany Medical College, Albany, NY, USA.
Injury epidemiology
|March 29, 2024
概括
实施普遍查和客观的儿童虐待识别协议显著增加了病例的发现. 这种方法有助于减少与种族和社会经济地位有关的偏见,在报告虐待儿童时.
科学领域:
- 儿科医学 儿科医学
- 虐待和忽视儿童的行为
- 医疗保健偏见研究研究
背景情况:
- 早期识别虐待儿童至关重要,以防止严重的后果.
- 提供者隐含偏见可能导致少数民族和贫困儿童在儿童虐待报告中的差异.
- 一个机构在2016年实施了普遍的滥用查,并在2019年实施了客观评估协议.
研究的目的:
- 评估普遍查和对儿童虐待识别的客观协议的影响.
- 评估已确认的虐待儿童案件的人口统计数据的变化.
- 确定这些干预措施是否能减轻报告中的种族和社会经济偏见.
主要方法:
- 对18岁以下患者 (2014-2022) 的回顾性图表审查和法医数据库分析.
- 三个时期的比较:普遍查前 (2014-2015年),普遍查后 (2016-2019年) 和协议后实施 (2020-2022年).
- 使用奇平方测试和修改的波桑回归来比较患者特征和病例识别率的统计分析.
主要成果:
- 普遍查显著增加了确诊的虐待儿童案件的数量.
- 人口特征发生了转变,白人儿童的识别率更高,与州人口统计数据保持一致.
- 公共保险患者的比例下降,与该州增加公共保险入学人数的趋势相反.
结论:
- 客观的,基于证据的协议在识别虐待儿童方面是有效的.
- 这些协议有望减少儿童虐待报告中的种族和社会经济偏见.
- 标准化协议的机构实施可以提高儿童虐待发现的准确性和公平性.
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