肺癌护理中的种族和城乡差异:从潜阶级增长分析的洞察力
Sohrab Jaferian1, Tanzy Love2, Sharad Kumar Singh3
1Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
Journal of cancer policy
|April 13, 2025
概括
分析肺癌护理途径揭示了差异. 黑人患者面临更高的不良结果风险,而农村患者的结果更好,尽管社会贫困更大.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康差距 研究 研究 研究 研究
背景情况:
- 在癌症治疗,特别是肺癌方面的健康差异在各种患者人口统计学中仍然存在.
- 肺癌仍然是美国癌症死亡的主要原因,这凸显了解决相关差异的紧迫性.
- 需要新的方法来可视化和理解导致这些差异的复杂因素.
研究的目的:
- 开发和应用一种新的方法,利用患者护理路径序列来可视化肺癌中的医疗保健差异.
- 确定不同患者群体之间护理路径的变化与不良健康结果的相关性.
- 调查种族,社会经济地位,地理位置 (城市/农村) 和肺癌结局之间的关系.
主要方法:
- 隐性类增长分析被用来将肺癌患者 (N=729) 根据他们的医疗保健访问序列分为不同的类别.
- 用危险建模来预测每个确定的患者类别的不良结果的概率.
- 在每个类别内的种族和城市/农村患者群体中分析了社会贫困指数 (SDI) 评分.
主要成果:
- 根据医疗保健利用模式的异质性,确定了三个不同的患者类别.
- 种族和城市/农村分布的显著差异在各类中被观察到 (p=0.004和<0.0005分别).
- 黑人患者的SDI得分始终高于白人患者,农村患者的SDI比城市患者高 (p<0.05).
- 黑人和城市患者在所有类别中,与白人和农村患者相比,对不良结果的纵向总风险更高.
结论:
- 护理路径序列显示,与白人患者相比,黑人患者的不良后果风险轨迹较少.
- 农村患者比城市患者取得更好的结果,即使面临更高的社会贫困.
- 这些发现强调了种族,地理,社会经济因素和护理途径在塑造肺癌结果中的复杂相互作用.
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