在缅因州的农村和城市紧急部门进行分拣评估的种族差异
Madeleine M Puissant1,2,3, Isha Agarwal4,5,6, Elizabeth Scharnetzki5
1Department of Emergency Medicine, Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA. Madeleine.Puissant@mainehealth.org.
紧急护理中的种族偏见仍然存在,非白人患者获得了较低的敏度分辨分数和更长的等待时间. 这种偏见主要出现在城市的急救部门,而不是农村的急救部门.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 紧急医疗 紧急医疗
背景情况:
- 隐性偏见不成比例地影响到紧急护理中的种族化群体.
- 紧急严重性指数 (ESI) 旨在客观分类,但主观偏见仍然存在.
- 了解与感知种族和解释者需求相关的偏见至关重要.
研究的目的:
- 为了检查感知种族,需要翻译员和紧急严重性指数 (ESI) 分数之间的关联.
- 调查医院地理 (城市与农村) 对急诊室 (ED) 选偏差的影响.
- 根据患者人口统计数据分析等待时间和床位分配的差异.
主要方法:
- 在缅因州卫生系统内的城市和农村ED的患者的回顾性电子病历 (EMR) 审查.
- 在5年的时间里,对十大主要投诉 (不包括精神病) 的分析.
- 多变量回归用于评估感知种族,翻译需求,性别,ESI得分,等待时间和走廊床分配之间的关系.
主要成果:
- 与白人患者相比,被认为不是白人的患者获得了较低的敏度ESI分数,并经历了较长的等待时间.
- 与男性患者相比,女性患者的敏度得分更低,等待时间更长的可能性更高.
- 翻译需求与更长的等待时间相关,但与ESI分数无关.
- 主观偏见在城市EDs中很明显,但在农村EDs中却没有.
结论:
- 在ED triage中隐含的偏见受到感知种族和性别的影响,导致护理优先级的差异.
- 地理位置显著影响选偏差的表现,城市环境显示出更多证据.
- 建议进一步研究缅因州城市急救部门内主观偏见,以解决发现的不平等问题.
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