根据种族和支付人的基础上对烧伤患者进行分组和录取
Samantha Steeman1, Devi Lakhlani1, Eloise Stanton2
1Stanford University School of Medicine, Stanford, CA, USA.
概括
与非营利机构相比,营利性烧伤中心接受的医疗补助 (Medi-Cal) 保险患者,特别是种族少数群体的患者较少. 这表明,在专业烧伤护理接入方面,存在着持续的差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 烧伤护理差异的差异
- 获得医疗保健 获得医疗保健 获得医疗保健
背景情况:
- 营利性医疗机构可能会根据保险状况影响患者的选择.
- 获得烧伤护理的机会至关重要,差异可能会不成比例地影响少数民族和低收入人群.
- 医疗补助 (Medi-Cal) 患者,通常是种族少数群体,在获得专门的烧伤治疗方面可能面临障碍.
研究的目的:
- 调查营利性烧伤中心是否接受较少的烧伤转移患者与安全网和非营利性中心相比.
- 分析烧伤中心利状况与接受治疗的Medi-Cal患者比例之间的关联.
- 确定影响不同类型燃烧中心接受燃烧转移的因素.
主要方法:
- 利用加利福尼亚州的全付费者数据库 (2009-2019) 来检查急诊部 (ED) 对烧伤患者的住院转移.
- 在营利性,非营利性和安全网烧伤中心中比较了Medi-Cal支付人的比例.
- 使用后勤回归来建模转移接受利中心的可能性,根据烧伤严重程度和人口统计情况进行调整.
主要成果:
- 在5,728个烧伤转移中,非营利性中心获得了89%的转移;37.3%的非营利性转移是Medi-Cal患者,而以营利为目的中心的这一比例为24.0% (p<.001).
- 黑人种族和西班牙裔种族独立地与转移到营利性烧伤中心的几率降低有关.
- 利状况与Medi-Cal转移有负相关性,而创伤和安全网状况没有显著的相关性.
结论:
- 根据保险和种族/种族,在烧伤护理方面仍然存在差异.
- 非营利性烧伤中心为更高比例的Medi-Cal和少数群体患者提供服务.
- 营利性中心似乎更喜欢商业保险的白人患者,这可能会加剧医疗保健不平等.
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