验证一种方法来调查跨性别患者的护理不平等
Kellyn Engstrom1, Fernanda Bellolio2,3, Molly Moore Jeffery2,3
1Mayo Clinic, Department of Pharmacy, Rochester, Minnesota.
The western journal of emergency medicine
|June 27, 2025
概括
这项研究开发了一种准确的电子健康记录 (EHR) 方法来识别跨性别和性别多样性 (TGD) 患者. 这种经过验证的方法可以更好地研究TGD个体经历的潜在护理差异.
科学领域:
- 医疗信息学 医疗信息学
- 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:
- 疼痛是急诊室 (ED) 常见的投诉.
- 种族/民族少数群体,妇女和老年人之间存在疼痛管理方面的差异.
- 跨性别和性别多样性 (TGD) 个体在紧急医疗中面临代表性不足和潜在的护理不平等.
研究的目的:
- 建立一个准确和可通用的过程,用于识别使用电子健康记录 (EHR) 的TGD患者.
- 创建和验证一种方法,将TGD患者与cisgender比较组相匹配.
- 为了进一步研究TGD人群所经历的护理差异.
主要方法:
- 在ED患者的腹痛患者的回顾性观察队列研究 (2018年7月至2022年11月).
- 从EHR注册字段中提取出生时分配的性别和性别认同.
- 通过独立调查员的审查和解决差异,验证了TGD患者的识别.
- 使用倾向性匹配得分来比较TGD患者与cisgender异性恋男性,cisgender异性恋女性,cisgender同性恋,双性恋,酷尔 (GBQ) 男性和cisgender女同性恋,双性恋,酷尔 (LBQ) 女性.
主要成果:
- 最初的EHR数据提取确定了300名TGD患者;另外包括1000名患者进行匹配.
- 与手动审查相比,TGD患者的电子识别显示出高准确性 (99.9%的同意,kappa 0.998).
- 大多数群体的匹配都取得了成功,但由于数量较少, cisgender GBQ男性遇到了挑战.
- 群体之间观察到显著的年龄差异, cisgender GBQ男性年龄较大.
结论:
- 基于EHR的方法识别TGD患者的方法是准确的,并根据手册审查进行验证.
- 这项研究提供了一种可靠的方法来识别TGD患者在EHR中,用于未来的研究.
- 这种经过验证的方法对于调查和解决TGD患者在紧急情况下面临的潜在护理不平等至关重要.
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