对于患有脏疾病的患者来说,医疗保健的感知和基于接待员的移植评估
Miriam Vélez-Bermúdez1, Yuridia Leyva1, Jamie M Loor1
1Center for Healthcare Equity in Kidney Disease, Office of Research, Health Sciences Center, The University of New Mexico, Albuquerque.
JAMA network open
|November 26, 2024
概括
简化移植 (KT) 评估改善了患者对医疗保健的看法,减少了对黑人和白人患者的歧视和不信任. 然而,它并没有提高黑人患者对医生的信任.
科学领域:
- 移植手术 移植手术
- 健康差异 在健康上的差异
- 患者体验 患者体验
背景情况:
- 移植 (KT) 评估是繁重的,特别是对于黑人患者来说,他们面临着更高的歧视和对医疗保健的不信任.
- 了解减轻患者负担是否可以改善医疗保健的感知和经验对于公平的KT接入至关重要.
研究的目的:
- 为了调查是否简化,主管式的KT评估改善了黑人和白人患者的医疗保健感知.
- 通过简化的KT评估过程,评估歧视,种族主义,医疗不信任和医生信任的变化.
主要方法:
- 在一个单一的城市移植中心进行前性队列研究,涉及820名成年KT合格患者 (25%黑人,75%白人).
- 患者完成了基线和随访问卷,评估KT评估前后的医疗保健经验.
- 用重复测量回归分析数据,分层按种族和时间分层.
主要成果:
- 与白人参与者相比,黑人参与者报告了较高的基线歧视,种族主义和不信任,以及较低的医生信任.
- 所有参与者在评估后显著减少了歧视和对医生的不信任.
- 黑人参与者也报告了较低的种族主义感知,但仅在黑人参与者中观察到医生信任的显著下降.
结论:
- 精简的KT评估过程可以提高患者对医疗保健系统的整体感知.
- 这种方法可能会减少歧视和不信任,但不一定会提高医生信任,特别是在黑人患者中.
- 需要进一步的研究来将这些感知变化与KT的结果和时间联系起来.
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