道路分道扬:绘制通往诊断健康公平的旅程
Lakshmi Krishnan1,2,3, Yvonne Commodore-Mensah4, Kelly T Gleason4
1Department of Medicine, Georgetown University, Washington, District of Columbia, USA lakshmi.krishnan@georgetown.edu.
BMJ open quality
|April 20, 2025
概括
诊断差异显著影响健康结果. 一个新的社会生态模型,即"诊断环境",解决了多层次的影响,以改善诊断公平并减少健康结果差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生社会学 卫生社会学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 诊断差异对不同社区的健康结果产生重大影响.
- 影响差异性获取和治疗的因素有助于诊断中的不平等.
- 了解可变的诊断途径对于解决健康差异至关重要.
研究的目的:
- 探索诊断和诊断不平等的复杂景观.
- 为了解和解决诊断差异提出一个社会生态模型.
- 整合对诊断过程和健康结果的多层次影响.
主要方法:
- 一种跨学科的方法,综合了来自各种知识领域的见解.
- 代讨论,视觉图表和叙事开发,以构建一个新的框架.
- 开发"诊断环境"模型,诊断旅程框架和问题星座.
主要成果:
- "诊断环境"模型概念化了超越生物医学过程的诊断.
- 确定了三种影响水平:大气 (社会因素),表面 (医疗互动) 和地下 (规范和偏见).
- 整合过程,社会现象和多层次影响,以全面解决诊断差异.
结论:
- 诊断过程受到个人和系统因素的影响,导致健康差异.
- 提出的社会生态模型为理解和干预诊断不平等提供了一个框架.
- 需要采用整体方法,通过解决因素的复杂相互作用来提高诊断准确性和公平性.
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