对住院儿科患者的行为标志的应用中的不公平
April Edwell1, Jia Xin Huang1, Tasce Bongiovanni2
1Department of Pediatrics, University of California, San Francisco.
JAMA network open
|February 20, 2025
概括
黑人和非裔美国儿童更有可能在他们的电子健康记录 (EHR) 中收到行为标志. 这项研究强调了儿科医疗保健中的不平等,特别是在年幼的黑人儿童身上,这表明在国旗分配方面存在偏见.
科学领域:
- 健康 公平 卫生 公平
- 儿科健康 儿科健康
- 医疗信息学 医疗信息学
背景情况:
- 电子健康记录 (EHR) 中的行为标志可以延续结构性种族主义和歧视.
- 了解行为风险标志物如何传达的不平等,对于改善医院的儿科患者和家庭体验至关重要.
研究的目的:
- 调查是否在种族和社会经济上被边缘化的儿科患者在他们的电子健康记录中被不成比例地分配行为标志.
- 为了确定特定的患者人口统计学与较高的行为旗放置率相关.
主要方法:
- 追溯队列研究,利用2012年6月至2021年7月期间在UCSF医疗保健机构住院的儿科患者 (<18岁) 的EHR数据.
- 分析包括超过55,000次儿科接触,检查行为标志的主要结果 (例如,目击物质滥用,安全,CPS持有).
- 分析的关键变量包括患者的种族,种族,保险状况和主要语言.
主要成果:
- 大约0.4% (55,865人中的236人) 的儿科接触有行为标志.
- 与白人患者相比,黑人或非裔美国患者的遭遇更有可能获得行为标志 (IRR,2.07).
- 有政府保险的患者比拥有私人保险的患者有更高的标志发病率 (IRR,2.60). 在8岁以下的黑人或非裔美国儿童中,悬挂国旗的可能性明显更高.
结论:
- 这项研究揭示了在种族和社会经济上被边缘化的儿科患者的电子健康记录中行为标志的发生率的重大不平等.
- 在年轻的黑人或非裔美国儿童中,放国旗的可能性增加表明,潜在的偏见与家庭种族有关,而不是个体患者的行为.
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