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荷兰城市医院中少数民族患者住院期间不良事件风险未增加:一项前瞻性观察性研究的结果

Ethnic minority patients not at increased risk of adverse events during hospitalisation in urban hospitals in the Netherlands: results of a prospective observational study.

作者信息

van Rosse Floor, Essink-Bot Marie-Louise, Stronks Karien, de Bruijne Martine, Wagner Cordula

机构信息

Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands Department of Public and Occupational Health, VU University Medical Center (VUmc), EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.

Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands.

出版信息

BMJ Open. 2014 Dec 30;4(12):e005527. doi: 10.1136/bmjopen-2014-005527.

Abstract

OBJECTIVES

We analysed potential differences in incidence, type, nature, impact and preventability of adverse events (AEs) during hospitalisation between ethnic Dutch and ethnic minority patients, and the role of patient-related determinants. We hypothesised an increased AE incidence for ethnic minority patients.

SETTING

We conducted a prospective cohort study in four urban hospitals.

PARTICIPANTS

763 Dutch patients and 576 ethnic minority patients aged between 45 and 75, admitted for at least one night, were included in the study. All patients completed a questionnaire on patient-related determinants (eg, language proficiency).

OUTCOME MEASURES

Incidence, type (eg, diagnostic AEs), impact and nature of AEs were assessed with a two-stage medical record review. Logistic regression analysis was used to adjust for patient and admission characteristics, and to investigate the contribution of patient-related determinants to AE risk.

RESULTS

There was no significant difference in the incidence of AEs: 11% (95% CI 9% to 14%) in Dutch patients and 10% (95% CI 7% to 12%) in ethnic minority patients. Also, there was no significant difference in the incidence of preventable AEs: 3% (95% CI 1% to 4%) in Dutch patients and 1% (95% CI 0% to 2%) in ethnic minority patients. Low language proficiency, inadequate health literacy and low educational level did not increase the risk of an AE.

CONCLUSIONS

Compared with Dutch patients, ethnic minority patients were not at increased risk of AEs while receiving care in Dutch hospitals. Healthcare providers seem to have responded effectively to specific patient care needs, but we do not know whether this occurred in an ad hoc or in a systematic way.

摘要

目的

我们分析了荷兰族裔和少数族裔患者住院期间不良事件(AE)的发生率、类型、性质、影响和可预防性的潜在差异,以及患者相关决定因素的作用。我们假设少数族裔患者的AE发生率会增加。

设置

我们在四家城市医院进行了一项前瞻性队列研究。

参与者

763名年龄在45至75岁之间、至少住院一晚的荷兰患者和576名少数族裔患者被纳入研究。所有患者都完成了一份关于患者相关决定因素(如语言能力)的问卷。

结果指标

通过两阶段病历审查评估AE的发生率、类型(如诊断性AE)、影响和性质。使用逻辑回归分析来调整患者和入院特征,并调查患者相关决定因素对AE风险的影响。

结果

AE的发生率没有显著差异:荷兰患者为11%(95%CI 9%至14%),少数族裔患者为10%(95%CI 7%至12%)。此外,可预防性AE的发生率也没有显著差异:荷兰患者为3%(95%CI 1%至4%),少数族裔患者为1%(95%CI 0%至2%)。低语言能力、健康素养不足和低教育水平并未增加AE的风险。

结论

与荷兰患者相比,少数族裔患者在荷兰医院接受治疗时发生AE的风险并未增加。医疗服务提供者似乎有效地回应了特定的患者护理需求,但我们不知道这是以临时方式还是系统方式发生的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff48/4281537/abc440eb0608/bmjopen2014005527f01.jpg

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