实际与最近分娩医院的种族和种族不平等
Nansi S Boghossian1, Lucy T Greenberg2, Jeffrey S Buzas3
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
JAMA network open
|March 21, 2025
概括
产科护理的种族差异仍然存在,美国印第安人和黑人经常接受质量较差的护理. 如果黑人个人在最近的医院分娩,这种不平等可能会减少,这突出了在获得孕产妇医疗保健方面的系统性问题.
科学领域:
- 产科和妇科 产科和妇科
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 包括美国印第安人和黑人在内的少数种族和民族群体,与白人相比,在医疗保健质量方面存在差异.
- 了解产科护理中的这些差异,特别是比较实际分娩医院与基于居住地的最近选项,是有限的.
研究的目的:
- 根据实际分娩医院与离分娩个体居住地邮政编码最近的医院对产科护理质量的差异进行检查.
- 量化在孕产妇医疗保健提供地点的种族和种族不平等.
主要方法:
- 一项基于人口的回顾性队列研究分析了2008年至2020年间来自美国5个州的数据.
- 包括22至44周妊娠年龄之间的胎儿死亡或活产的个体.
- 使用吉尼系数和标准化病率比率计算了产科不平等指数,以比较跨种族和种族群体的医院质量.
主要成果:
- 与白人相比,美国印第安人和黑人个人在质量较差的医院分娩.
- 亚洲人和西班牙裔人与白人人之间没有观察到医院质量的显著差异.
- 黑人居住在质量较差的医院附近;在最近的医院分娩会减少这个群体的不平等.
结论:
- 与白人相比,在美国印第安人和黑人分娩的医院的质量存在显著差异.
- 对于黑人来说,如果他们使用最近的医院进行分娩,那么护理质量的差距可以缩小.
- 调查结果强调需要解决导致获得高质量的产科护理机会不平等的系统因素.
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