Department of Public Health, Academic Medical Center, Meibergdreef 9, Amsterdam, AZ 1105, The Netherlands.
BMC Health Serv Res. 2012 Dec 7;12:450. doi: 10.1186/1472-6963-12-450.
While US studies show a higher risk of adverse events (AEs) for ethnic minorities in hospital care, in Europe ethnic inequalities in patient safety have never been analysed. Based on existing literature and exploratory research, our research group developed a conceptual model and empirical study to increase our understanding of the role ethnicity plays in patient safety. Our study is designed to (1) assess the risk of AEs for hospitalised patients of non-Western ethnic origin in comparison to ethnic Dutch patients; (2) analyse what patient-related determinants affect the risk of AEs; (3) explore the mechanisms of patient-provider interactions that may increase the risk of AEs; and (4) explore possible strategies to prevent inequalities in patient safety.
We are conducting a prospective mixed methods cohort study in four Dutch hospitals, which began in 2010 and is running until 2013. 2000 patients (1000 ethnic Dutch and 1000 of non-Western ethnic origin, ranging in age from 45-75 years) are included. Survey data are collected to capture patients' explanatory variables (e.g., Dutch language proficiency, health literacy, socio-economic status (SES)-indicators, and religion) during hospital admission. After discharge, a two-stage medical record review using a standardized instrument is conducted by experienced reviewers to determine the incidence of AEs. Data will be analysed using multilevel multivariable logistic regression. Qualitative interviews with providers and patients will provide insight into the mechanisms of AEs and potential prevention strategies.
This study uses a robust study plan to quantify the risk difference of AEs between ethnic minority and Dutch patients in hospital care. In addition we are developing an in-depth description of the mechanisms of excess risk for some groups compared to others, while identifying opportunities for more equitable distributions of patient safety for all.
虽然美国的研究表明少数民族在医院护理中发生不良事件（AE）的风险更高，但在欧洲，患者安全方面的种族不平等从未得到分析。基于现有文献和探索性研究，我们的研究小组开发了一个概念模型和实证研究，以增加我们对种族在患者安全中所扮演角色的理解。我们的研究旨在：（1）评估与荷兰族裔患者相比，非西方族裔住院患者发生 AE 的风险；（2）分析哪些与患者相关的决定因素会影响 AE 的风险；（3）探索可能增加 AE 风险的医患互动机制；（4）探索预防患者安全不平等的可能策略。
我们正在四家荷兰医院进行一项前瞻性混合方法队列研究，该研究始于 2010 年，持续到 2013 年。共纳入 2000 名患者（1000 名荷兰族裔和 1000 名非西方族裔，年龄在 45-75 岁之间）。在住院期间，通过调查收集患者的解释变量（例如，荷兰语熟练程度、健康素养、社会经济地位（SES）指标和宗教信仰）。出院后，由经验丰富的审核员使用标准化工具对医疗记录进行两阶段回顾，以确定 AE 的发生率。将使用多级多变量逻辑回归分析数据。对提供者和患者进行定性访谈，以深入了解 AE 的发生机制和潜在的预防策略。
本研究采用了稳健的研究计划，以量化少数民族和荷兰族裔患者在医院护理中发生 AE 的风险差异。此外，我们正在深入描述某些群体与其他群体相比发生超额风险的机制，同时确定为所有人提供更公平的患者安全分配的机会。
