在急诊室处置决定中识别具有显著种族和性别差异的患者亚群
Peter Lin1, Nilay T Argon1, Qian Cheng1
1Department of Statistics and Operations Research, University of North Carolina, Chapel Hill, NC, USA.
Health services insights
|September 9, 2024
概括
紧急诊所 (ED) 录取的种族和性别差异仍然存在,特别是影响非裔美国女性. 这些差异凸显了有针对性的干预措施的必要性,以确保在所有患者子组中提供公平的护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 紧急医疗 紧急医疗
背景情况:
- 在急诊室 (ED) 处置决策中的种族和性别差异得到了广泛的记录.
- 确定具有明显差异的特定人口和临床子组对于有针对性的研究至关重要.
研究的目的:
- 确定人口统计和临床子组,在ED倾向中经历最显著的种族性别差异.
- 为制定有针对性的干预措施提供信息,以解决潜在的医疗保健差异.
主要方法:
- 对93,987名白人和非裔美国成年人的回顾性分析,紧急严重性指数为3.
- 利用随机森林来确定关键变量 (Elixhauser并发病率得分,年龄,保险) 用于亚种群分析.
- 采用后勤回归来评估已识别的亚种群中的种族性别差异.
主要成果:
- 与白人男性相比,非裔美国女性的入学率明显较低 (OR低至0.304).
- 非洲裔美国男性和白人女性在特定的年龄,并发病症和保险子组中也经历了较低的入院率.
- 在所有分析的子组中,非裔美国女性的差异仍然存在.
结论:
- 在各种患者亚组中,在ED入院的可能性上存在显著的种族性别差异.
- 年龄较小,并发病率较低,以及某些保险状态 (医疗补助,自付) 与对差异的脆弱性增加有关.
- 非洲裔美国妇女一直面临较低的入学率,这强调了干预的关键领域.
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