Asghar Zahid, Phung Viet-Hai, Siriwardena Aloysius Niroshan
Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK.
East Midlands Ambulance Service NHS Trust, UK.
J Eval Clin Pract. 2016 Oct;22(5):721-5. doi: 10.1111/jep.12523. Epub 2016 Mar 10.
Few studies have investigated the quality of pre-hospital care by ethnicity. We aimed to investigate ethnic differences in pre-hospital ambulance care of patients with suspected cardiac pain.
We conducted a cross-sectional analysis of retrospective electronic clinical data for patients with suspected cardiac pain over one year (August 2011 to July 2012) extracted from a single regional ambulance service. This included patient demographic data, clinical measurements, drugs administered and outcomes, such as transportation to hospital or referral to primary care. We used multivariate regression to investigate differences in care by ethnicity comparing non-White with White patients.
There were 7046 patients with suspected cardiac pain, with 4825 who had ethnicity recorded including 4661 (96.6%) White and 164 (3.4%) non-White. After correcting for age, sex, socio-economic status and whether transported to hospital, non-White patients were significantly more likely to have temperature [odds ratio (OR) 2.96, P = 0.007], blood glucose (OR 3.95, P = 0.003), respiratory rate (OR 4.94, P = 0.03) and oxygen saturation (OR 2.43, P = 0.006) recorded. Non-White patients were significantly less likely to be transported to hospital (OR 0.43, P = 0.03).
There were significant differences in pre-hospital ambulance care for non-White compared with White patients with suspected cardiac pain. These differences could be due to differences in clinical condition or case-mix, language and cultural barriers, limited understanding of appropriate use of health care services, recording bias or true differences in provider management. Further analysis should involve larger and more complete data sets to explore ethnic differences in greater detail.
很少有研究按种族调查院前护理质量。我们旨在调查疑似心脏疼痛患者的院前急救护理中的种族差异。
我们对从一个地区性救护车服务机构提取的一年（2011年8月至2012年7月）内疑似心脏疼痛患者的回顾性电子临床数据进行了横断面分析。这包括患者人口统计学数据、临床测量、所使用的药物以及诸如送往医院或转诊至初级护理机构等结果。我们使用多变量回归来调查非白人患者与白人患者在护理方面的差异。
共有7046例疑似心脏疼痛患者，其中4825例记录了种族信息，包括4661例（96.6%）白人患者和164例（3.4%）非白人患者。在校正年龄、性别、社会经济地位以及是否被送往医院后，非白人患者记录体温[比值比（OR）2.96，P = 0.007]、血糖（OR 3.95，P = 0.003）、呼吸频率（OR 4.94，P = 0.03）和血氧饱和度（OR 2.43，P = 0.006）的可能性显著更高。非白人患者被送往医院的可能性显著更低（OR 0.43，P = 0.03）。
与疑似心脏疼痛的白人患者相比，非白人患者的院前急救护理存在显著差异。这些差异可能是由于临床状况或病例组合、语言和文化障碍、对适当使用医疗服务的理解有限、记录偏差或提供者管理方面的真实差异。进一步的分析应涉及更大且更完整的数据集，以更详细地探讨种族差异。
