Clark-Hitt Rose, Malat Jennifer, Burgess Diana, Friedemann-Sanchez Greta
Department of Communication at Michigan State University, MI, USA.
J Health Care Poor Underserved. 2010 Feb;21(1):386-400. doi: 10.1353/hpu.0.0275.
Racial inequality in medical treatment is a problem whose sources are not fully understood. To gain better insight into how race may affect treatment, semi-structured interviews were conducted with 26 doctors and nurses. Using an open coding scheme, the explanations of racial inequality in treatment were coded by two people. Four major categories of responses emerged to explain why Black patients are less likely to receive the same levels of medical care as Whites: access to care, physician bias, Black patients' perceived shortcomings, and White patients' demands. Interviewees commonly cited access and patient factors before naming physician bias. The majority questioned the validity of studies reporting disparities. Educational campaigns should emphasize evidence that racial disparities persist even after controlling for factors such as insurance and patient characteristics. Educational programs should also address subconscious racial bias and how it may operate in a clinical setting.
医疗治疗中的种族不平等是一个根源尚未完全明了的问题。为了更深入地了解种族如何影响治疗，我们对26名医生和护士进行了半结构化访谈。采用开放式编码方案，由两人对治疗中种族不平等的解释进行编码。出现了四大类回应来解释为什么黑人患者比白人患者获得同等水平医疗护理的可能性更低：获得医疗服务的机会、医生偏见、黑人患者被认为的缺点以及白人患者的要求。受访者在提及医生偏见之前通常会提到获得医疗服务的机会和患者因素。大多数人对报告差异的研究的有效性提出质疑。教育活动应强调即使在控制了保险和患者特征等因素之后，种族差异仍然存在的证据。教育项目还应解决潜意识的种族偏见以及它在临床环境中可能如何起作用的问题。
