Herrod Henry G, Chang Cyril F
Department of Pediatrics, University of Tennessee Health Science Center and The Urban Child Institute, Memphis, Tennessee 38105, USA.
Clin Pediatr (Phila). 2008 Mar;47(2):128-36. doi: 10.1177/0009922807306166. Epub 2007 Sep 14.
This study was conducted to determine if the Agency for Healthcare Research and Quality's newly established pediatric quality monitors, which measure potentially avoidable hospitalizations, are useful in detecting disparities in health care delivery. Data for all hospital discharges in Tennessee in 2002 were evaluated for the 5 pediatric discharge monitors identified by the Agency for Healthcare Research and Quality. These diagnoses were asthma, short-term complications of diabetes, gastroenteritis, urinary tract infection, and perforated appendix. Black children were more likely to be discharged with the diagnoses of asthma and short-term diabetes complications. Publicly insured children were more likely than commercially insured children to be discharged with each of the 5 potentially avoidable hospitalizations. The results show that black children and children insured by public programs have significantly different discharge rates for pediatric potentially avoidable hospitalizations than do white children or commercially insured children. This could be the result of less access to high-quality ambulatory care.
本研究旨在确定医疗保健研究与质量局新设立的儿科质量监测指标(用于衡量潜在可避免的住院情况)是否有助于发现医疗服务提供中的差异。对田纳西州2002年所有医院出院数据进行评估,以分析医疗保健研究与质量局确定的5项儿科出院监测指标。这些诊断包括哮喘、糖尿病短期并发症、肠胃炎、尿路感染和阑尾穿孔。黑人儿童更有可能因哮喘和糖尿病短期并发症诊断而出院。与商业保险儿童相比,公共保险儿童因5种潜在可避免住院情况中的每一种而出院的可能性更大。结果表明,与白人儿童或商业保险儿童相比,黑人儿童和参加公共项目保险的儿童在儿科潜在可避免住院方面的出院率存在显著差异。这可能是由于获得高质量门诊护理的机会较少所致。