Kerker Bonnie D, Leventhal John M, Schlesinger Mark, Horwitz Sarah M
New York City Department of Health and Mental Hygiene, New York, NY 10013, USA.
Ethn Dis. 2006 Winter;16(1):28-34.
To determine whether providers' medical history-taking of substance use varies with their patients' race or ethnicity.
DESIGN/SETTING/PARTICIPANTS: The medical records of 1083 low-income women who delivered at an urban teaching hospital over a 12-month period were reviewed and data were abstracted. The frequency with which the presence or absence of substance use was documented was compared among Black, Hispanic, and White women. Multivariate models predicting documentation of data on substance use were also built.
Information on substance use was more often documented in the medical records of Black and Hispanic women than in those of White women. For example, 74% of Black women, 78% of Hispanic women, and 60% of White women had data on cocaine use documented in their medical records (P= .0001). Multivariate analyses found that, after controlling for other factors, Black (odds ratio [OR] 4.1) and Hispanic (OR 5.3) non-clinic patients were more likely than White non-clinic patients to have documented data on substance use history in their medical records. No racial/ ethnic disparities were found among clinic patients. Among White women, clinic patients were more likely than non-clinic patients to have documented data on substance use. Among other races and ethnicities, no disparities were found between places of care.
The differential collection of information on women's medical histories may be influenced by organizational factors and/or provider factors. The standard implementation of history-taking protocols would reduce the influence of institutional and personal biases on the care provided to pregnant women and enable all patients to receive appropriate referrals to treatment.
确定医疗服务提供者对药物使用情况的病史询问是否因患者的种族或族裔而异。
设计/地点/参与者：回顾了1083名在城市教学医院分娩的低收入妇女在12个月期间的病历，并提取了数据。比较了黑人、西班牙裔和白人妇女中记录有或没有药物使用情况的频率。还建立了预测药物使用数据记录情况的多变量模型。
与白人妇女相比，黑人妇女和西班牙裔妇女病历中关于药物使用的信息记录得更频繁。例如，74%的黑人妇女、78%的西班牙裔妇女和60%的白人妇女病历中有可卡因使用的数据记录（P = 0.0001）。多变量分析发现，在控制其他因素后，黑人（优势比[OR]4.1）和西班牙裔（OR 5.3）非门诊患者比白人非门诊患者更有可能在病历中有药物使用史的数据记录。在门诊患者中未发现种族/族裔差异。在白人妇女中，门诊患者比非门诊患者更有可能有药物使用的数据记录。在其他种族和族裔中，护理地点之间未发现差异。
女性病史信息的差异收集可能受组织因素和/或医疗服务提供者因素的影响。实施统一的病史询问方案将减少机构和个人偏见对孕妇护理的影响，并使所有患者都能获得适当的治疗转诊。
