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卫生保健质量中的种族和民族差异。

Racial and Ethnic Disparities in the Quality of Health Care.

机构信息

Departments of Family Medicine and Public Health Sciences, University of Rochester Medical Center, Rochester, New York 14620; email:

出版信息

Annu Rev Public Health. 2016;37:375-94. doi: 10.1146/annurev-publhealth-032315-021439. Epub 2016 Jan 18.

Abstract

The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.

摘要

《年度国家医疗保健质量和差异报告》记录了广泛而持续的种族和民族差异。这些差异是由患者的社会劣势相关因素、临床医生以及组织和医疗保健系统因素之间复杂的相互作用导致的。各州之间、医疗保健系统之间以及临床医生之间存在着分离且不平等的医疗保健体系,限制了满足弱势群体需求的可用资源,导致了不平等的结果,并强化了隐性偏见。最近的数据表明,许多领域进展缓慢,但也记录了在消除这些差异方面的一些显著成功。为了消除这些差异,需要全国上下齐心协力,通过扩大医疗保险覆盖范围、支持初级保健以及根据既定的、有限的目标取得进展,为基于证据、有充足资源、多层次的质量改进策略提供公共问责制,这些策略需要让患者、临床医生、医疗保健组织和社区参与进来,从而确保医疗保健公平。

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