等待医院床位:急诊室入院的差异
Rose M Olson1,2, Nathaniel Fessehaie1,2, Trishathi Malagar Nandakumar1
1Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
黑人和其他边缘化的种族/民族群体经历了更长的急诊室 (ED) 登机时间,医疗保险差异导致不平等. 针对性的干预措施对于解决这一公共卫生危机至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 紧急医疗 紧急医疗
背景情况:
- 紧急部门 (ED) 登机是一个重要的公共卫生问题.
- 现有的研究还没有明确确定是否存在种族和民族差异在ED登机时间.
研究的目的:
- 调查紧急部门入院时间的种族和种族不平等问题.
- 探索可能导致ED登机时间延长的因素,例如健康保险状况.
主要方法:
- 一项回顾性队列研究分析了从2018年3月到2024年2月在波士顿两家医院接受内部医学服务的38766名成年患者.
- 患者按种族和种族分类:白人,黑人,西班牙裔和其他.
- 长时间的急救登机被定义为从入院命令到住院转移的4个小时或更长时间. 使用多变量后勤回归和调解分析 (医疗保险).
主要成果:
- 与白人患者相比,黑人患者 (9%更高的几率) 和"其他"种族/种族群体 (16%更高的几率) 面临的ED登机时间明显更长.
- 与白人患者相比,西班牙裔患者登机时间在统计学上没有显著差异.
- 医疗保险状况,特别是医疗补助,是一个重要的调解者,与所有种族和种族群体的登机时间增加有关,特别是对于黑人和西班牙裔患者.
结论:
- 在ED登机时间的种族和民族差异不成比例地影响黑人和"其他"边缘化群体.
- 不同的医疗保险类型和获得医疗保险的差异似乎是导致这些不平等的关键因素.
- 迫切的,有针对性的干预措施是必要的,以减轻这些差异,因为ED登机在全国范围内继续增加.
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