Cabana Michael D, Lara Marielena, Shannon Jay
Department of Pediatrics, University of California, San Francisco, 3333 California St, Suite 245, San Francisco, CA 94118, USA.
Chest. 2007 Nov;132(5 Suppl):810S-817S. doi: 10.1378/chest.07-1910.
Racial and ethnic disparities in the quality of asthma care have been well documented in the United States. There are multiple factors associated with such disparities in asthma care, including structural barriers (eg, ability to access the health-care system), process-of-care barriers (eg, ability to navigate the health-care system), and process-of-care barriers at the interpersonal level (eg, ability to work effectively with a health-care provider) for equitable, quality asthma care. This article summarizes these issues and identifies specific areas for future investigation. At a health-systems level, further work is needed to understand how medical care financing arrangements may or may not be contributing to racial and ethnic disparities in asthma care, as well as how specific organizational initiatives can address these issues. Research needs at the patient/provider level include defining the content and methods for disseminating issues regarding cultural competency to health-care providers.
在美国,哮喘护理质量方面的种族和族裔差异已有充分记录。哮喘护理方面的这种差异与多种因素相关,包括结构障碍(例如,获得医疗保健系统的能力)、护理过程障碍(例如,在医疗保健系统中顺利就医的能力)以及人际层面的护理过程障碍(例如,与医疗保健提供者有效合作的能力),以实现公平、高质量的哮喘护理。本文总结了这些问题,并确定了未来调查的具体领域。在卫生系统层面,需要进一步开展工作,以了解医疗保健融资安排可能如何或是否导致哮喘护理方面的种族和族裔差异,以及特定的组织举措如何解决这些问题。患者/提供者层面的研究需求包括确定向医疗保健提供者传播文化能力相关问题的内容和方法。