Maeno M, Sakuyama M, Motoyama S, Matsuo H
Kobe University Graduate School of Health Sciences, Japan.
Clin Exp Obstet Gynecol. 2012;39(4):442-7.
The objectives of this research were to examine the current status of perioperative treatment among foreigners, to elucidate the health status/outcome disparities that contribute to ethnic differences, and to recommend counter-measures to rectify these ethnic disparities. The authors identified 36 non-Japanese and 111 Japanese females who underwent gynecological surgery from 2004 to 2009 at a single institution. Electronic medical records were reviewed and telephone survey was conducted in order to obtain patient background, preoperative, operative, and postoperative data. The non-Japanese group showed significantly larger number of uninsured, shorter length of stay (LOS), higher rate of emergency surgery, and higher cases of spinal anesthesia. There were significant differences in length of residency in Japan and LOS among four foreign countries. Seventy-nine percent of patients contacted by phone understood informed consent from doctors, 73.7% understood explanation in operating room (OR), and 84.2% understood explanation from anesthesiologists. This research was the first survey of the ethnic disparities in perioperative management among foreign patients treated in Osaka. The authors have demonstrated differences in operative method, emergency surgery, anesthesia, and American Society of Anesthesiologists physical status (ASA-PS) due to the difference in disease structure, language, and culture. It is recommended that the barriers between non-Japanese patients and medical staff are rectified during the perioperative period when mutual understanding is needed the most.
本研究的目的是调查外国人围手术期治疗的现状，阐明导致种族差异的健康状况/结果差异，并提出纠正这些种族差异的对策。作者确定了2004年至2009年在一家机构接受妇科手术的36名非日本女性和111名日本女性。回顾电子病历并进行电话调查，以获取患者背景、术前、术中及术后数据。非日本组 uninsured人数显著更多、住院时间（LOS）更短、急诊手术率更高以及脊髓麻醉病例更多。四个外国国家在日本的居住时间和住院时间存在显著差异。79%通过电话联系的患者理解医生的知情同意，73.7%理解手术室（OR）的解释，84.2%理解麻醉医生的解释。本研究是对大阪接受治疗的外国患者围手术期管理中种族差异的首次调查。作者证明了由于疾病结构、语言和文化的差异，手术方法、急诊手术、麻醉和美国麻醉医师协会身体状况（ASA - PS）存在差异。建议在最需要相互理解的围手术期纠正非日本患者与医务人员之间的障碍。
