长时间入院和种族歧视以及急诊室患者之间的不满
Rose McKeon Olson1,2, Andrea Fleurant1, Sophie Grace Beauparlant1
1Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA network open
|September 16, 2024
概括
延长急诊室 (ED) 登机时间与患者歧视和不满情绪的增加有关. 这些影响可能会对边缘化的种族和民族群体产生不成比例的影响,突显出需要健康公平解决方案.
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
- 紧急医疗 紧急医疗
背景情况:
- 紧急部门 (ED) 的登机时间显著增加.
- 长时间的ED登机对健康公平结果的影响在很大程度上是未知的.
- 了解这些差异对于解决医疗保健中的系统不平等至关重要.
研究的目的:
- 调查长时间的ED登机与感知到的种族歧视和不满之间的联系.
- 检查这些关联是否在边缘化种族/民族群体和非西班牙裔白人患者之间有所不同.
- 为了确定由于ED登机而导致的健康不平等的潜在恶化.
主要方法:
- 城市医院住院成年人的横截面研究ED.
- 平等比例的非西班牙裔白人和边缘化的种族/民族群体的纳入.
- 通过医疗机构歧视量表和Picker患者体验-15问卷收集数据.
- 多变量后勤回归分析,调整人口和保险因素.
主要成果:
- 登机24小时或更长时间与感知歧视 (OR,1.84) 和不满意度 (OR,1.77) 的增加有关,而这与不到4小时的登机时间相比.
- 在边缘化群体中,长时间登机和歧视之间存在更强的联系 (OR,2.36).
- 根据种族/种族对影响的修改对于歧视或不满是没有统计学意义的.
结论:
- 经历长时间ED登机的住院患者报告了更高水平的歧视和不满.
- 这些发现表明,延长ED登机可能会加剧健康不平等,特别是在边缘化人口中.
- 需要紧急,以公平为重点的干预措施,以减轻增加ED登机时间的负面影响.
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