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对外科手术结果和护理中种族/民族差异的认识:影响认知与行动的因素

Awareness of racial/ethnic disparities in surgical outcomes and care: factors affecting acknowledgment and action.

作者信息

Britton Breanne V, Nagarajan Neeraja, Zogg Cheryl K, Selvarajah Shalini, Schupper Alexander J, Kironji A Gatebe, Lwin Albert T, Cerullo Marcelo, Salim Ali, Haider Adil H

机构信息

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Center for Surgery and Public Health, Harvard Medical School, Harvard T.H. Chan School of Public Health, and the Department of Surgery, Brigham and Women's Hospital, Boston, MA 02120, USA.

出版信息

Am J Surg. 2016 Jul;212(1):102-108.e2. doi: 10.1016/j.amjsurg.2015.07.022. Epub 2015 Oct 29.

Abstract

BACKGROUND

Studies have demonstrated racial/ethnic disparities in surgical outcomes and care. Surgeon awareness and its association with institutional action remain unclear. The study sought to assess surgeons' awareness of racial/ethnic disparities, ascertain whether demographic and practice factors influence acknowledgement of disparities, and determine whether surgeons are seeking to mitigate disparities.

METHODS

Anonymous online survey was administered to a random sample of American College of Surgeons (ACS) general surgeons (July 2013 to March 2014). Responses were weighted for nonresponse and risk-adjusted using logistic regression.

RESULTS

172 surgeons completed the survey. Levels of acknowledged disparities were low. Less than one half reported institutional efforts to address disparities, and less than one fourth had taken efforts to investigate disparities in their personal practice. Several respondent factors including Academic Medical Center affiliation, awareness of the ACS statement on optimal access, and year of medical school graduation significantly associated with expressed acknowledgment of disparities.

CONCLUSIONS

Such associations speak to the need for continued efforts to promote enhanced provider awareness and participation. As the field of surgical disparities moves from understanding to action, we must acknowledge the contributing role that providers play.

摘要

背景

研究已表明手术结果和护理方面存在种族/民族差异。外科医生的认知及其与机构行动的关联仍不明确。本研究旨在评估外科医生对种族/民族差异的认知,确定人口统计学和实践因素是否会影响对差异的认知,并判断外科医生是否在寻求减轻差异。

方法

对美国外科医师学会(ACS)普通外科医生的随机样本进行匿名在线调查(2013年7月至2014年3月)。对未回复情况进行加权处理,并使用逻辑回归进行风险调整。

结果

172名外科医生完成了调查。对差异的认知水平较低。不到一半的人报告了机构为解决差异所做的努力,不到四分之一的人在个人实践中努力调查差异。包括学术医疗中心附属关系、对ACS关于最佳医疗服务可及性声明的认知以及医学院毕业年份在内的几个受访者因素与对差异的明确认知显著相关。

结论

这些关联表明需要持续努力以提高医疗服务提供者的认知和参与度。随着手术差异领域从认知转向行动,我们必须认识到医疗服务提供者所起的作用。

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