新生儿药物测试中的种族差异,在实施了基于问题的产前物质使用查后,新生儿药物测试的种族差异
Alexandra Soos1, Melissa Plegue, Adam Darwiche
1Department of Family Medicine, the Susan B. Meister Child Health Evaluation and Research Center, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
Obstetrics and gynecology
|June 6, 2024
概括
基于问题的普遍查减少了产前药物测试,特别是对于黑人分娩父母. 然而,它并没有降低新生儿药物测试率,也没有解决这些测试中存在的种族不平等问题.
科学领域:
- 公共卫生 公共卫生
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 健康 公平 卫生 公平
背景情况:
- 产前物质使用查对母亲和婴儿的福祉至关重要.
- 在医疗保健中存在种族差异,包括怀孕期间的物质使用测试.
- 基于问题的普遍查旨在标准化和潜在地减少护理中的不平等.
研究的目的:
- 评估基于问题的普遍查对产前物质使用的影响.
- 评估这种查方法与产前和新生儿药物检测中的种族不平等的关联.
主要方法:
- 在 (2014-2017) 之前和 (2018-2022) 查实施后,对32,802名出生者的回顾性队列研究.
- 使用后勤回归分析产前和新生儿药物测试订单的分析.
- 对患者病历的审计,用于指导方针导向的护理,这些患者报告说有困难停止使用物质.
主要成果:
- 基于问题的查与产前尿液药物测试订单 (5.0%至3.1%) 的显著下降有关.
- 黑人分娩父母在产前检测中出现了最大的减少 (10.3%至4.9%).
- 新生儿药物检测率保持不变 (4.7%至4.5%),种族差异持续显著,有利于黑人新生儿.
结论:
- 基于问题的普遍查减少了产前药物测试,但没有改变新生儿药物测试率或相关的种族不平等.
- 需要进一步的政策干预,以改善物质使用治疗和消除惩罚性做法,如新生儿药物测试.
- 解决新生儿药物测试和儿童保护服务报告中的种族不平等问题需要有针对性的政策努力.
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