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黑人和白人患者在附近中风中心认证后的结果

Yu-Chu Shen^1,2, Anthony S Kim³, Renee Y Hsia^4,5

¹Department of Defense Management, Naval Postgraduate School, Monterey, California.

JAMA network open

|July 28, 2025

概括

脑卒中中心认证增加了黑人和白人患者的脑卒中中心入院率. 然而,急性中风治疗和死亡率的差异仍然存在,黑人患者的结果更差.

科学领域:

医疗保健服务研究医疗服务研究
心血管疾病心血管疾病
健康公平卫生公平

背景情况:

卒中中心认证旨在改善急性缺血性卒中护理和结果.
现有的研究并未明确这些好处是否同样适用于黑人和白人患者.

研究的目的:

评估附近中风中心认证对黑人与白人患者中风护理和结果的影响.
确定中风中心认证有效性的潜在差异.

主要方法:

对210万被诊断患有急性缺血性中风的Medicare服务费患者 (2009-2019) 的差异分析.
对照中风中心入院,血栓抑制剂,血栓切除和90天家庭状态/暴露和未暴露社区之间的1年死亡率的比较变化,按种族分层.

主要成果:

脑卒中中心认证增加了脑卒中中心的入院人数,对黑人和白人患者来说也是如此.
白人患者的血栓溶解剂使用增加,而黑人患者的血栓溶解剂和血栓切除率下降.
白人患者的一年死亡率保持稳定,但黑人患者的死亡率增加.

结论:

虽然中风中心认证改善了获取机会,但它并不能消除急性中风治疗利用的种族差异.
黑人患者治疗的持续差异和死亡率更差的结果表明,除了中心认证之外,还有系统性问题.

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