emergency medicine at University of California, San Francisco, and emergency medicine at San Francisco General Hospital, USA.
Health Aff (Millwood). 2012 Aug;31(8):1767-76. doi: 10.1377/hlthaff.2011.1020.
It is well documented that racial and ethnic minority populations disproportionately use hospital emergency departments for safety-net care. But what is not known is whether emergency department crowding is disproportionately affecting minority populations and potentially aggravating existing health care disparities, including poorer outcomes for minorities. We examined ambulance diversion, a proxy measure for crowding, at 202 California hospitals. We found that hospitals serving large minority populations were more likely to divert ambulances than were hospitals with a lower proportion of minorities, even when controlling for hospital ownership, emergency department capacity, and other hospital demographic and structural factors. These findings suggest that establishing more-uniform criteria to regulate diversion may help reduce disparities in access to emergency care.
有大量文献记载表明，少数族裔人群不成比例地使用医院急诊部门来获得保障性医疗服务。但目前还不清楚急诊部门的拥堵是否不成比例地影响到少数族裔人群，以及是否可能加剧现有的医疗保健差距，包括少数族裔的治疗效果更差。我们调查了 202 家加利福尼亚医院的救护车分流情况，这是衡量拥堵的一个替代指标。我们发现，服务于大量少数族裔人群的医院比少数民族比例较低的医院更有可能分流救护车，即使在控制医院所有权、急诊部门容量和其他医院人口统计和结构因素后也是如此。这些发现表明，制定更加统一的标准来规范分流可能有助于减少急诊护理获取方面的差距。
