在心力衰竭诊断的设置中公平:对临床医师实践之间和内部差异的分析
Anshal Gupta1, Rebecca L Tisdale2,3, Jamie Calma4
1Stanford University School of Medicine, Palo Alto, CA (A.G.).
Circulation. Heart failure
|June 7, 2024
概括
心力衰竭 (HF) 诊断设置的差异仍然存在,边缘化群体更常被诊断为急性护理. 在门诊实践中提高公平性可以提高所有患者的及时HF诊断.
科学领域:
- 心脏病学 心脏病学
- 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:
- 及时诊断心力衰竭对于早期干预和降低发病率至关重要.
- 历史上被边缘化的患者更有可能在急性护理机构 (急诊室或住院住院) 接受新发性HF诊断,而不是门诊机构.
- 门诊临床医师实践中的不平等对HF诊断设置的影响仍然不清楚.
研究的目的:
- 确定2013年至2017年医疗保险收费服务受益者之间发生高温热诊断的设置.
- 确定与急性护理机构中HF诊断相关的社会人口统计和医疗特征.
- 评估门诊临床医师实践中的不平等是否影响HF诊断设置.
主要方法:
- 在315,439名医疗保险收费服务受益者 (2013-2017年) 中分析了发生的HF诊断.
- 在门诊临床医生实践中,通过社会人口统计学因素 (性别,种族/种族,双重资格) 对急症诊断率的比较.
- 基于急性诊断率的公平性和实践特征的比较,临床医师实践的分层化.
主要成果:
- 超过一半 (54.9%) 的HF病例是在急性护理机构诊断的.
- 更高的调整急性护理诊断率与女性性别,美洲印第安人种族和双重医疗保险-医疗补助资格有关.
- 这些差异在临床医师实践中持续存在,双重资格患者的急性护理诊断率显著增加.
结论:
- 在急性护理机构内,临床医生实践之间和内部存在高频率诊断率的显著差异.
- 这些发现强调了改善历史边缘化人口诊断公平的机会.
- 门诊临床医生实践公平与性别和种族/种族以及初级保健组成的公平相关.
关键词:
医疗补助公司 (Medicaid) 的医疗补助.美国医疗保险 (Medicare) 的医疗保险.卫生公平性健康公平性医疗服务的可访问性心脏衰竭是因为心脏衰竭.疾病发病率 疾病发病率 疾病发病率初级医疗保健是一项主要的医疗保健服务.更多相关视频
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