医生-病人种族一致性和新生儿死亡率
George J Borjas1,2,3, Robert VerBruggen2
1Harvard Kennedy School, Harvard University, Cambridge, MA 02138.
概括
婴儿死亡率的种族差距表明,黑人新生儿可能有更好的生存率与黑人医生. 然而,当控制出生体重非常低时,这种效应显著减少,这表明其他因素更为关键.
科学领域:
- 公共卫生 公共卫生
- 新生儿医学 新生儿医学
- 健康差异 在健康上的差异
背景情况:
- 婴儿死亡率的种族差异是一个重要的公共卫生问题.
- 之前的研究表明,黑人新生儿在接受黑人医生治疗时的生存率有所提高,即使在控制了各种因素之后.
研究的目的:
- 复制和扩展以前关于医生种族与黑人婴儿死亡率之间的关联的发现.
- 为了调查出生时体重非常低在这种关联中的作用.
主要方法:
- 对1992年至2015年佛罗里达州医院出院数据的分析.
- 复制一项先前的研究,控制医院和医生固定的影响和常见的并发症.
- 扩展模型以包括出生体重非常低 (<1500克) 的诊断.
主要成果:
- 之前观察到的黑人新生儿和黑人医生之间的生存一致性效应在控制非常低出生体重时大幅减少.
- 在包括非常低出生体重,医院和医生固定效应的模型中,该效应接近于零,并且在统计学上无意义.
结论:
- 非常低的出生体重是影响新生儿死亡率的关键因素,可能会混医生种族的明显影响.
- 医生种族和黑人婴儿存活率之间的关联在考虑关键临床因素 (如出生体重非常低) 时并不强大.
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