Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA. Natalie
J Public Health Manag Pract. 2010 Jul-Aug;16(4):329-36. doi: 10.1097/PHH.0b013e3181c4d933.
We examined health disparities and disproportionality in child protective services (CPS) reporting at a regional academic health center.
We computed disproportionate representation and disparity indices from archived CPS reports for pediatric patients (N = 1,020) from 2002 to 2006.
Findings indicated that medical personnel reported African American and Hispanic pediatric patients to CPS (1) at higher rates than their representation in the general pediatric patient population and (2) at a rate approximately four times that of White pediatric patients. However, White pediatric patients were reported to CPS at lower rates than their general pediatric patient representation. Additional examination of socioeconomic factors demonstrated that pediatric patients from poor neighborhoods were reported to CPS (1) at higher rates than their numbers in the patient population and (2) five times more often than pediatric patients from prosperous neighborhoods.
We found significant racial/ethnic and socioeconomic disproportionality and disparities in medical personnel's CPS reporting practices. These findings augment the limited literature investigating disparities and disproportionality in medical personnel's CPS reporting practices. The inclusion of pediatric and general departments allows for increased generalizability of study results. However, more rigorous empirical examination is needed to identify the causal factors responsible for noted differences. Consequently, healthcare systems' collection and examination of patients' racial/ethnic data are imperative to effectively address the multifaceted, social welfare issues of health disparities and disproportionality.
我们考察了某地区学术医疗中心儿童保护服务(CPS)报告中的健康差异和不成比例现象。
我们对 2002 年至 2006 年期间的儿童保护服务报告中的儿科患者(n=1020)进行了不成比例代表和差异指数的计算。
研究结果表明,医务人员向 CPS 报告的非裔美国人和西班牙裔儿科患者(1)比他们在一般儿科患者人群中的代表性更高,(2)比白人儿科患者的报告率高出约四倍。然而,白人儿科患者向 CPS 的报告率却低于他们在一般儿科患者中的代表性。对社会经济因素的进一步研究表明,来自贫困社区的儿科患者向 CPS 的报告率(1)高于他们在患者群体中的数量,(2)比来自富裕社区的儿科患者高五倍。
我们发现医务人员在 CPS 报告实践中存在显著的种族/民族和社会经济不成比例和差异。这些发现增加了对医务人员在 CPS 报告实践中存在差异和不成比例现象的有限文献的研究。包括儿科和普通科可以提高研究结果的普遍性。然而,需要更严格的实证检验来确定导致这些差异的因果因素。因此,医疗保健系统收集和审查患者的种族/民族数据对于有效解决健康差异和不成比例现象的多方面社会福利问题至关重要。