一个贝叶斯驱动的方法来识别在纵向护理交付中的种族不平等
Aidan M Campbell1,2, A James O'Malley1,2,3,4, Inas S Khayal5,6,7,8,9
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
NPJ digital medicine
|November 6, 2025
概括
这项研究引入了一种时间意识的方法,以发现宿舍护理中的种族差异. 它揭示了临终关怀启动的时间,而不仅仅是整体接入,对于理解晚期癌症患者的医疗保健公平至关重要.
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
- 老年学是一门学科.
背景情况:
- 医疗保健质量和公平性指标往往忽视了医疗保健提供时间.
- 这种忽视可能会掩盖患者治疗结果的重大种族差异.
- 了解时间模式对于准确的健康公平评估至关重要.
研究的目的:
- 开发和应用一种新的,时间意识的方法来检测宿舍利用中的种族不平等.
- 分析晚期癌症患者在生命的最后200天的临终关怀启动模式.
- 为了确定种族差异出现的具体时间点.
主要方法:
- 一种时间意识的方法,在生命的最后200天里每天跟踪临终关怀的开始.
- 引入每日"差异信号",以量化使用模式的变化.
- 利用贝叶斯的框架来量化不确定性和临床上有意义的值来确定差异.
主要成果:
- 时间感知方法揭示了传统的,时间不可知测量方法无法发现的大量日间种族差异.
- 虽然总体数据表明白人患者更容易进入临终关怀,但时间分析显示,在许多情况下,有色人种患者更早开始临终关怀.
- 护理的时间显著改变了对临终关怀中种族平等的看法.
结论:
- 时间意识的方法提供了更细致的了解在医疗保健利用种族不平等.
- 确定差异的精确时间为健康公平干预提供了更可行的目标.
- 这种方法可以通过突出护理获取的时间维度来为未来的数字健康公平努力提供信息.
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