Weddington W H, Gabel L L, Peet G M, Stewart S O
Department of Family Medicine, Ohio State University, Columbus 43210.
J Natl Med Assoc. 1992 Jul;84(7):569-75.
Even with major advancements in medical knowledge and significant improvements in health sciences technology, evidence still exists that blacks do not enjoy as full a measure of health as do other racial and ethnic groups. To attempt a better understanding of this situation, literature was reviewed to consider relationships between being black and issues related to quality of health care. It was determined that these relationships have not been studied to any great extent, either in quantity or quality. When such studies have been undertaken, they have been limited to mostly qualitative designs, and appropriate controls for confounding variables have been minimal. The psychiatric literature reports most of the studies with very few studies found in the literature of other specialties. A conceptual model is presented regarding race-related research. It is argued that a first step might be to study whether the quality of care differs when the physician and the patient are members of different racial groups compared with when the physician and patient are members of the same racial group. In all race-related research, it is necessary to carefully consider specific variables that may confound results, eg, diagnostic errors, age, sex, socioeconomic status, level of education, geographic locale, and method of payment for health-care services.
即便医学知识取得了重大进展，健康科学技术也有了显著提升，但仍有证据表明，黑人并未像其他种族和族裔群体那样享有充分的健康水平。为了更好地理解这种情况，我们查阅了相关文献，以探讨黑人身份与医疗保健质量相关问题之间的关系。结果发现，无论是在数量还是质量上，这些关系都没有得到深入研究。在进行此类研究时，大多局限于定性设计，对混杂变量的适当控制也微乎其微。精神病学文献报道了大部分此类研究，而其他专业领域的文献中此类研究则很少。本文提出了一个关于种族相关研究的概念模型。有人认为，第一步或许是研究当医生和患者属于不同种族群体时，与医生和患者属于同一种族群体时相比，医疗保健质量是否存在差异。在所有与种族相关的研究中，都必须仔细考虑可能混淆结果的特定变量，例如诊断错误、年龄、性别、社会经济地位、教育水平、地理位置以及医疗保健服务的支付方式。
