提前护理计划,种族和年龄
Rebecca E Berger1, Monika M Safford1, Jennifer I Lee1
1Division of General Internal Medicine, Weill Department of Medicine, Weill Cornell Medicine, New York, NY.
概括
在调整了患者因素后,对于通用医学住院患者的预先护理规划 (ACP) 服务中没有观察到种族差异. 需要进一步分析以了解和解决健康差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 医疗信息学 医疗信息学
背景情况:
- 在终身护理和预先护理计划 (ACP) 中存在种族差异是有记录的.
- 目前尚不清楚这些差异是否可以通过其他变量来解释.
研究的目的:
- 确定在对潜在混因素进行调整后,在一般医疗病房患者中,在ACP服务中是否存在种族差异.
- 调查人口和临床因素对非洲和非洲国家和地区供应的影响.
主要方法:
- 来自学术医疗中心的电子健康记录的二次分析.
- 包括2022年7月至2023年6月期间出院的有限预期寿命的通用医学住院患者.
- 使用波桑回归来分析患者特征与ACP服务 (息治疗咨询,住院出院,舒适护理或ACP注释) 之间的关联.
主要成果:
- 分析包括552名患者的580次住院治疗 (平均年龄73.8岁,51.3%非西班牙裔白人).
- 未经调整的分析显示,非西班牙裔黑人患者接受非洲和非洲国家医疗服务的可能性较低.
- 根据年龄,性别,保险和医疗状况进行调整,消除了明显的种族差异.
结论:
- 在对混因素进行调整后,在一般医疗住院患者中,在ACP服务中明显的种族差异并没有持续.
- 准确评估质量改善中的健康差异需要对潜在的混变量进行调整.
- 进一步的研究应该探索影响不同患者群体中ACP提供服务的细微因素.
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