Becker Davida, Tsui Amy O
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.
Perspect Sex Reprod Health. 2008 Dec;40(4):202-11. doi: 10.1363/4020208.
Eliminating racial and ethnic disparities in health care is an important national priority. Despite substantial research documenting such disparities, this topic has received limited attention in the reproductive health field.
Logistic regression was used to test for group differences in three service delivery preferences and five service quality perceptions among a nationally representative sample of 1,741 low-income black, Latina and white women aged 18-34; the data were collected in 1995 and represent the most recent data available for looking at these issues.
English-speaking Latinas and Spanish-speaking Latinas were more likely than whites to prefer a female clinician at their visits (odds ratios, 1.8 and 3.6, respectively) and to highly value clinician continuity (1.7 and 2.2). English-speaking Latinas and blacks were more likely than whites to prefer receiving reproductive health care at a site delivering general health care (1.5 and 1.6). Both groups of Latinas were less likely than whites to give the facility environment or the patient-centeredness at their most recent reproductive health visit the highest rating (0.3-0.5). Blacks were more likely than whites to report ever having been pressured by a clinician to use contraceptives (2.3).
Efforts to reduce racial, ethnic and language group differences in clients' perceptions of reproductive health service quality should focus on improving client-clinician communication, the service environment and contraceptive counseling. Future research should continue to assess group differences and try to determine their underlying causes.
消除医疗保健中的种族和族裔差异是一项重要的国家优先事项。尽管有大量研究记录了这些差异，但该主题在生殖健康领域受到的关注有限。
采用逻辑回归分析，在一个具有全国代表性的样本中，对1741名年龄在18 - 34岁的低收入黑人、拉丁裔和白人女性的三种服务提供偏好和五种服务质量认知进行组间差异测试；数据收集于1995年，是可用于研究这些问题的最新数据。
说英语的拉丁裔和说西班牙语的拉丁裔比白人更倾向于在就诊时选择女性临床医生（优势比分别为1.8和3.6），并高度重视临床医生的连续性（1.7和2.2）。说英语的拉丁裔和黑人比白人更倾向于在提供综合医疗保健的场所接受生殖健康护理（1.5和1.6）。两组拉丁裔在最近一次生殖健康就诊时，给设施环境或以患者为中心的评价低于白人（0.3 - 0.5）。黑人比白人更有可能报告曾受到临床医生使用避孕药具的压力（2.3）。
减少客户对生殖健康服务质量认知中的种族、族裔和语言群体差异的努力应集中在改善医患沟通、服务环境和避孕咨询上。未来的研究应继续评估群体差异，并试图确定其潜在原因。
