测量医疗保险医院入院的当地区域种族隔离
Ellesse-Roselee L Akré1, Deanna Chyn2, Heather A Carlos3
1Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
JAMA network open
|April 19, 2024
概括
美国医院的种族隔离是显著的,大多数医院显示不同的种族入院模式比他们的市场. 这项研究开发了一种新的测量方法来量化黑人患者之间的差异.
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
- 医学社会学 医学社会学
背景情况:
- 美国医院存在显著的种族隔离,超出了住宅模式.
- 现有的测量医院隔离的方法是有限的.
研究的目的:
- 开发和应用一种新的指标,即当地医院隔离 (LHS) 指数,以量化医疗保健市场中老年黑人患者的种族分类.
- 评估医院接受黑人患者的程度,与他们在当地市场的代表性成比例.
主要方法:
- 追溯横截面分析2019年医疗保险索赔数据对于65岁以上的服务费入学者的数据.
- 根据驾驶时间定义了医院市场,并将LHS指数计算为医院入院种族组成和市场种族组成之间的差异.
- 分析了从2022年11月到2024年1月的数据.
主要成果:
- 这项研究分析了1,991家医院的4,870,252名患者入院情况.
- 近80%的医院表现出与其市场区域明显不同的种族入院模式.
- 医院级LHS与政府医院地位有积极的关联;像纽约,芝加哥和底特律这样的特定地区显示出高区域LHS.
结论:
- 一个新的地方医院隔离 (LHS) 指数被开发来衡量种族入院差异.
- 大多数美国医院都表现出明显的种族入院模式,与周围患者群体不同.
- 了解医院选择动态对于解决医疗保健结果中的种族不平等至关重要.
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