Lambert Trevor W, Goldacre Michael J, Vallance Elizabeth, Mallick Netar
UK Medical Careers Research Group, Department of Public Health, University of Oxford, Oxford OX3 7LF.
BMJ. 2004 Jun 5;328(7452):1347. doi: 10.1136/bmj.38062.639190.44. Epub 2004 Apr 16.
To determine whether women, ethnic minorities, and particular specialties are discriminated against in the receipt of NHS distinction awards.
Analysis of database of consultants eligible for distinction awards.
England and Wales, 2002.
Holding of B, A, and Aplus distinction awards, analysed for all awards, irrespective of when made, and for awards made in the last five years studied.
Women and doctors from ethnic minorities were substantially under-represented among award holders when no account was taken of potential confounding factors. Differences diminished after multivariate analysis, but some remained significant. For example, the adjusted odds ratio of women holding awards compared with men was 0.69 (95% confidence interval 0.59 to 0.82) for any award and 1.37 (0.86 to 2.20) for Aplus awards; the odds ratio for any award for non-white doctors trained abroad compared with white doctors trained in the United Kingdom was 0.45 (0.37 to 0.56). In the last five years studied the adjusted ratio of women to men was 0.94 (0.79 to 1.10) for B awards and 1.54 (0.85 to 2.83) for Aplus awards. The adjusted ratio for non-white British trained consultants was 0.86 (0.62 to 1.17) for B awards and 1.20 (0.37 to 3.87) for Aplus awards; for non-white consultants trained abroad it was 0.68 (0.54 to 0.85) for B awards and 0.69 (0.15 to 3.10) for Aplus awards; and for white consultants trained abroad it was 0.70 (0.54 to 0.91) for B awards and 0.90 (0.38 to 2.15) for Aplus awards.
Historical under-representation in award holding by women and doctors from ethnic minorities was partly explained by time spent as a consultant. Recent awards showed no under-representation of women and no appreciable under-representation of ethnic minorities overall. However, doctors who trained abroad-both white and non-white-remained under-represented for B awards.
确定女性、少数族裔以及特定专业的人员在获得英国国家医疗服务体系（NHS）杰出奖方面是否受到歧视。
对符合杰出奖资格的顾问数据库进行分析。
2002年，英格兰和威尔士。
持有B级、A级和A+级杰出奖的情况，分析所有奖项，无论何时颁发，以及在研究的过去五年内颁发的奖项。
在不考虑潜在混杂因素时，女性和少数族裔医生在获奖者中所占比例严重偏低。多因素分析后差异有所减小，但仍有一些差异显著。例如，女性获得任何奖项与男性相比的调整优势比为0.69（95%置信区间0.59至0.82），获得A+级奖项的优势比为1.37（0.86至2.20）；在国外接受培训的非白人医生获得任何奖项与在英国接受培训的白人医生相比的优势比为0.45（0.37至0.56）。在研究的过去五年中，女性获得B级奖项与男性的调整比例为0.94（0.79至1.10），获得A+级奖项的比例为1.54（0.85至2.83）。在英国接受培训的非白人顾问获得B级奖项的调整比例为0.86（0.62至1.17），获得A+级奖项的比例为1.20（0.37至3.87）；在国外接受培训的非白人顾问获得B级奖项的比例为0.68（0.54至0.85），获得A+级奖项的比例为0.69（0.15至3.10）；在国外接受培训的白人顾问获得B级奖项的比例为0.70（0.54至0.91），获得A+级奖项的比例为0.90（0.38至2.15）。
女性和少数族裔医生在获奖方面历史上代表性不足的部分原因是担任顾问的时间。最近的奖项显示女性没有代表性不足，少数族裔总体上也没有明显的代表性不足。然而，在国外接受培训的医生——包括白人和非白人——在获得B级奖项方面仍然代表性不足。
