Lurie Nicole, Fremont Allen, Jain Arvind K, Taylor Stephanie L, McLaughlin Rebecca, Peterson Eric, Kong B Waine, Ferguson T Bruce
RAND Corporation, 1200 S Hayes St, Arlington, VA 22202, USA.
Circulation. 2005 Mar 15;111(10):1264-9. doi: 10.1161/01.CIR.0000157738.12783.71.
Despite extensive documentation of racial and ethnic disparities in care, provider awareness of disparities has been thought to be low. To be effective, educational efforts for physicians must consider providers' knowledge and beliefs about what causes disparities and what can be done about them.
We conducted a Web-based survey of 344 cardiologists to determine their level of awareness of disparities and views of underlying causes. Responses were assessed by means of 5-point Likert scales. Thirty-four percent of cardiologists agreed that disparities existed in care overall in the US healthcare system, and 33% agreed that disparities existed in cardiovascular care. Only 12% felt disparities existed in their own hospital setting, and even fewer, 5%, thought disparities existed in the care of their own patients. Despite this, most respondents rated the strength of the evidence about disparities as "very strong" or "strong." Respondents identified many potential causes for disparities in care but were more likely to endorse patient and system level factors (eg, insurance status or adherence) rather than provider level factors.
Cardiologists' awareness of disparities in care remains low, and awareness is inversely proportional to proximity to their own practice setting.
尽管医疗保健中种族和民族差异的记录广泛，但一直认为医疗服务提供者对这些差异的认知程度较低。为了有效，针对医生的教育工作必须考虑医疗服务提供者对差异产生原因以及如何解决这些差异的知识和信念。
我们对344名心脏病专家进行了一项基于网络的调查，以确定他们对差异的认知水平和对潜在原因的看法。通过5点李克特量表对回答进行评估。34%的心脏病专家同意美国医疗保健系统中总体医疗存在差异，33%同意心血管医疗存在差异。只有12%的人认为自己所在的医院存在差异，甚至更少，5%的人认为自己患者的护理存在差异。尽管如此，大多数受访者将有关差异的证据强度评为“非常强”或“强”。受访者确定了护理差异的许多潜在原因，但更倾向于认可患者和系统层面的因素（如保险状况或依从性）而非医疗服务提供者层面的因素。
心脏病专家对护理差异的认知仍然较低,且认知与他们自身执业环境的接近程度成反比。
