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在克拉米迪亚和淋病检测中缓解种族和民族差异的缓解
Michelle L Pickett1, Rachel Cafferty2, Chella Palmer3
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
概括
全球提供的克拉米迪亚 (CT) 和淋病 (GC) 测试,以电子健康记录 (EHR) 临床决策支持 (CDS) 为指导,减少了青少年测试中的种族差异. 这种方法确保了所有患者的公平性健康查.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 青少年医学 青少年医学
背景情况:
- 与白人同龄人相比,少数群体青少年的克拉米迪亚 (CT) 和淋病 (GC) 检测率更高.
- 干预对于解决和减轻这些人群在医疗保健提供方面的偏见至关重要.
- 现有的差异需要在医疗保健系统内找到创新的解决方案.
研究的目的:
- 评估电子健康记录 (EHR) 集成的临床决策支持 (CDS) 是否可以减少青少年CT/GC测试中的种族和民族差异.
- 为了比较有针对性的CT/GC测试策略与普遍提供的CT/GC测试策略的有效性.
- 评估CDS对基于种族和种族的差异测试的影响.
主要方法:
- 一项涉及6个儿科急诊室的前性实用试验的二次分析.
- 针对性CT/GC测试 (基于风险评估的CDS) 与普遍提供的测试 (由患者愿望触发的CDS) 的比较.
- 后勤回归分析用于比较两个阶段测试率的种族和民族差异.
主要成果:
- 在基线期间,少数群体,特别是非西班牙裔黑人患者,比非西班牙裔白人患者 (aOR=2.10) 更容易接受CT/GC测试.
- 有针对性的CDS并没有改变这些差异,差异测试仍然存在 (P=.35).
- 全球提供的CT/GC测试与EHR-CDS集成,成功地减轻了种族和民族差异,导致跨群体的测试比例相似 (P=.01).
结论:
- 全球提供的CT/GC测试,在EHR嵌入式CDS的帮助下,有效地减少了儿科急诊室中青少年测试的种族和民族差异.
- 这一战略促进了对所有青少年的更公平的性健康查,无论种族或种族.
- 使用CDS实施普遍提供的测试是一种可行的方法,以解决在STI查中的医疗保健偏见.
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