急性冠状动脉综合征的种族和民族差异:全国代表性样本
Geetika Srivastava1, Laith Alhuneafat2, Ahmad Jabri3
1Department of Internal Medicine, MetroHealth System/Case Western Reserve University, Cleveland, Ohio.
概括
在急性冠状动脉综合征 (ACS) 中存在种族和民族差异. 尽管并发病率较高,黑人和西班牙裔患者的死亡率较低,但与白人患者不同,死亡率更高.
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:
- 在急性冠状动脉综合征 (ACS) 结果中,在种族和种族群体中观察到显著的差异.
- 需要当代数据来评估不同人群的资源利用和住院治疗结果.
研究的目的:
- 评估各种种族和种族群体对急性冠状动脉综合征 (ACS) 的资源利用和住院治疗结果的差异.
- 分析住院并发症,住院时间和总住院费用的差异.
主要方法:
- 利用美国国家住院样本 (NIS) 数据库对2015年至2018年美国与ACS相关的医院出院情况进行了分析.
- 采用国际疾病分类第十版临床修改 (ICD-10-CM) 代码来识别关键变量.
- 使用STATA版本17进行统计分析.
主要成果:
- 包括1,911,869名ACS出院者:78.6%为白人,12.1%为黑人,9.3%为西班牙裔.
- 西班牙裔和黑人患者比白人患者年轻,患有更多的心脏代谢并发症 (高血压,糖尿病,肥胖).
- 西班牙裔患者的总医院费用较高;黑人患者接受再血管化的可能性最低.
- 与黑人和西班牙裔患者相比,白人患者的住院死亡率更高.
结论:
- 尽管伴随性疾病负担和社会经济挑战较高,但黑人和西班牙裔患者的ACS在医院死亡率低于白人患者.
- 西班牙裔患者面临的是每次ACS入院的最高总医院费用.
- 调查结果突出了ACS护理,资源使用和跨种族和民族的结果的复杂差异.
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