在美国,根据社区不利地位提供中风护理服务,2009-2022年
Renee Y Hsia1,2, Nandita Sarkar3, Yu-Chu Shen3,4
1Department of Emergency Medicine, University of California, San Francisco.
JAMA network open
|July 25, 2024
概括
在社会经济上处于不利地位的社区的医院获得中风中心认证的可能性明显较小. 这种差异凸显出需要有针对性的支持,以减少中风护理中的健康不平等.
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
- 脑卒中护理分娩提供服务
背景情况:
- 卒中中心的认证意味着治疗中风患者的先进能力.
- 了解认证方面的差异对于解决社会经济弱势群体的健康不平等至关重要.
研究的目的:
- 调查弱势社区的医院是否不太可能采用中风认证.
- 根据社区的劣势,检查入门级与高级中风认证的采用率之间的差异.
主要方法:
- 一项队列研究分析了2009-2022年期间来自5055家美国医院的数据.
- 考克斯的比例危险和竞争性风险模型评估了基于社区社会经济劣势 (区域贫困指数) 的中风认证采用的可能性.
主要成果:
- 与混合优势社区相比,最弱势社区的医院采用任何中风认证的风险要低42%.
- 在弱势社区,采用更高级别的中风认证的可能性明显较小.
- 即使在调整后,弱势社区的中风认证采用率也较低.
结论:
- 在社会经济弱势地区的医院在获得中风中心认证方面面临重大障碍.
- 需要进行干预,以支持这些医院获得认证,以减轻中风护理差异.
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