在医院之间通过种族,种族和保险来描述差异性护理的替代方法
Alina Kung1, Yingtong Chen1, Bian Liu2
1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
International journal of environmental research and public health
|October 29, 2025
概括
一项新的综合措施更有效地识别了为不成比例的少数民族和公共保险患者服务的医院. 这种方法捕获了更多的设施,揭示了质量差异,并为不同的人口提供服务,而不是单一的特征措施.
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
- 健康差异 在健康上的差异
背景情况:
- 服务于少数民族和公共保险人口的医院往往对患者的治疗结果较差.
- 目前用于识别这些医院的方法通常集中在一个特征上,例如黑人患者的比例.
研究的目的:
- 开发和评估一项更广泛的措施,用于识别不成比例地为少数民族和公共保险患者服务的医院.
- 为了比较这个新的测量与传统的单一特征方法.
主要方法:
- 利用服务费用医疗保险数据来对医院进行分类.
- 制定了一个综合措施,考虑多种患者特征 (黑人,西班牙裔,少数民族,双重资格出院) 和当地市场平均值.
- 评估了医院分类中的重叠和医院质量评级中的差异.
主要成果:
- 综合测量发现28.1%的医院服务不成比例,而使用单一特征的医院服务率为10%.
- 在医院星级质量评级中发现了中等差异 (平均差异为0.57-0.87,p < 0.001).
- 综合措施确定了更小的,更多的农村医院,为亚洲和美洲印第安人提供服务.
结论:
- 综合措施提供了更全面的方法来识别服务于不成比例的少数民族和公共保险人口的医院.
- 这种增强的识别可以揭示质量差异,并更好地服务于不同的患者群体.
- 未来的研究应该采用这种联合措施,以改善健康公平评估.
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