Kilbourne Amy M, Switzer Galen, Hyman Kelly, Crowley-Matoka Megan, Fine Michael J
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pa 15240, USA.
Am J Public Health. 2006 Dec;96(12):2113-21. doi: 10.2105/AJPH.2005.077628. Epub 2006 Oct 31.
We provide a framework for health services-related researchers, practitioners, and policy makers to guide future health disparities research in areas ranging from detecting differences in health and health care to understanding the determinants that underlie disparities to ultimately designing interventions that reduce and eliminate these disparities. To do this, we identified potential selection biases and definitions of vulnerable groups when detecting disparities. The key factors to understanding disparities were multilevel determinants of health disparities, including individual beliefs and preferences, effective patient-provider communication; and the organizational culture of the health care system. We encourage interventions that yield generalizable data on their effectiveness and that promote further engagement of communities, providers, and policymakers to ultimately enhance the application and the impact of health disparities research.
我们为与卫生服务相关的研究人员、从业者和政策制定者提供了一个框架,以指导未来在健康差异研究方面的工作,研究领域涵盖从发现健康和医疗保健方面的差异,到理解造成差异的决定因素,最终设计出减少和消除这些差异的干预措施。为此,我们在检测差异时确定了潜在的选择偏倚和弱势群体的定义。理解差异的关键因素是健康差异的多层次决定因素,包括个人信念和偏好、有效的医患沟通以及医疗保健系统的组织文化。我们鼓励开展能产生关于其有效性的可推广数据的干预措施,并促进社区、提供者和政策制定者的进一步参与,以最终提高健康差异研究的应用和影响。