在一个大规模的全州卫生系统中,老年人中低价值护理的种族和民族差异
Carlos Irwin A Oronce1,2,3, Ray Pablo4, Susi Rodriguez Shapiro5
1Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Journal of the American Geriatrics Society
|February 3, 2025
概括
在老年人中存在低价值护理 (LVC) 的种族差异. 虽然一些少数群体的LVC总体较少,但他们更有可能获得低价值的处方,强调需要采取具体措施.
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
- 老年医学 老年医学
背景情况:
- 基于价值的支付模式越来越多地整合了健康公平和低价值护理 (LVC) 的指标.
- 了解LVC的种族差异对于开发有效的健康公平干预措施至关重要.
- 本研究研究了当代患者队列中的LVC的种族差异.
研究的目的:
- 测量和分析老年人使用低价值护理 (LVC) 的种族差异.
- 为了识别特定类型的LVC,这些类型因种族和种族而异.
- 为制定针对健康公平的有针对性的干预措施提供信息.
主要方法:
- 在加利福尼亚州五个学术医疗中心 (2019-2021) 对55岁及以上的成年人索赔数据的横截面分析.
- 纳入标准:接受可归类为LVC的服务的患者.
- 多变量回归模型根据患者特征和医疗中心进行调整,以评估种族/种族和LVC结果之间的关联.
主要成果:
- 样本 (N=15,720) 包含59%的非西班牙裔白人,17%的亚洲裔,8%的拉丁裔,5%的非西班牙裔黑人老年人,他们可能接受LVC.
- 与白人老年人相比,亚裔,黑人和拉丁裔老年人总体而言不太可能接受LVC,特别是预防和手术前服务.
- 相反,亚裔,黑人和拉丁裔老年人更有可能接受低价值的处方药.
结论:
- 在不同临床类别的LVC中,种族模式的差异表明了不同的潜在机制.
- 这些发现强调了使用临床特异性LVC测量比复合测量更重要.
- 综合措施可能会掩盖重要的异质性,可能导致加剧不平等的干预.
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