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在美国麻醉师协会分类中评估种族偏见
Michael A Jacobs1, Brenna N McKaig2, Susanne Schmidt3
1Center for Healthcare Evaluation, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
The Journal of surgical research
|January 21, 2026
概括
在美国麻醉学会 (ASA) 的分类系统中存在种族偏见,影响手术风险评估和潜在的医疗保健差异. 这些发现表明需要修订ASA类分配,以确保公平的患者护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 健康 公平 卫生 公平
背景情况:
- 美国麻醉学会 (ASA) 的分类是手术风险评估,患者护理决策和赔偿的标准.
- 现有的研究还没有充分探索ASA分类系统中的种族/种族偏见.
- 由于这种偏见,潜在的医疗保健差异需要进行调查.
研究的目的:
- 调查美国麻醉学会 (ASA) 分类系统中的潜在种族/种族偏见.
- 在控制关键的外科手术风险因素后,评估跨种族和民族ASA类分配的差异.
主要方法:
- 一项回顾性队列研究分析了350,187名退伍军人卫生管理局和4,051,185名非退伍军人卫生管理局的手术病例.
- 种族/种族群体在风险分析指数 (手术虚弱度指标) 和手术前急性严重疾病上进行了匹配.
- 使用统计分析评估了ASA类的差异,包括调整的赔率比率和置信区间.
主要成果:
- 在匹配后,与白人患者相比,黑人患者的ASA类较高 (调整后的ORs=1.37,1.07).
- 与白人患者相比,西班牙裔患者的ASA类较低 (调整后ORs=0.96,0.96),尽管这一发现显示了灵敏度分析的变化.
- 这些差异表明,基于种族/种族的ASA类分配存在潜在的偏见.
结论:
- ASA分类系统显示了种族/种族的差异,这表明偏见可能会加剧医疗保健差异.
- 这种偏见对患者的结果,手术前护理,手术延迟,成本和质量改善举措有实际影响.
- 修订ASA类分配,可能通过带有偏见保护措施的自动化系统,或采用替代性发病率措施,可能是确保公平护理的必要.
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