医院分配和医疗保健中的种族差异
Amitabh Chandra1, Pragya Kakani2, Adam Sacarny3
1Harvard Kennedy School, Harvard Business School, and NBER.
概括
患有心脏病发作的黑人患者在表现较差的医院接受护理. 然而,医院的表现有所改善,显著减少了差异,原因是诸如β-阻断剂的采用,而不是患者重新分配等因素.
科学领域:
- 医疗服务研究 医疗服务研究
- 卫生公平性健康公平性
- 心血管医学 心血管医学
背景情况:
- 医疗保健中的种族差异仍然存在,黑人患者经常在质量较差的医院接受治疗.
- 了解这些差异的驱动因素对于开发有效的干预措施至关重要.
研究的目的:
- 开发一个框架来衡量医院分配在心脏病发作患者的种族差异中的作用.
- 分析两十年来医院绩效和患者分配的趋势.
主要方法:
- 开发了一个新的框架来量化医院分配对种族差异的影响.
- 分析了黑色和白色心脏病发作患者医院分配和结果的数据.
- 在20年的时间里,检查了医院绩效和患者重新分配的变化.
主要成果:
- 与白人患者相比,黑人患者在表现较差的医院接受过不成比例的治疗.
- 在过去的二十年中,医院绩效差距显著减少 (超过三分之二).
- 这种减少主要归因于服务于黑人患者的医院的快速绩效改善,而不是患者重新分配.
- 医院改善与采用β抑制剂相关.
结论:
- 医院绩效的提高,特别是与采用β阻断剂等治疗方法相关,是减少心脏病发作护理种族差异的关键驱动力.
- 虽然医院分配起着作用,但专注于改善现有设施的护理质量是减少差异的更有效策略.
- 未来的努力应利用绩效改进和战略重新分配来进一步减少医疗保健不平等.
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