非裔美国人的肾脏移植中的健康差异。
Health Disparities in Kidney Transplantation for African Americans.
机构信息
Monarch Innovation Partners, Inc., Rockville, MD, USA.
出版信息
Am J Nephrol. 2017;46(2):165-175. doi: 10.1159/000479480. Epub 2017 Aug 5.
BACKGROUND
The persistent challenges of bridging healthcare disparities for African Americans (AAs) in need of kidney transplantation continue to be unresolved at the national level. This healthcare disparity is multifactorial: stemming from limited kidney donors suitable for AAs; inconsistent care coordination and suboptimal risk factor control; social determinants, low socioeconomic status, reduced access to care; and mistrust of clinicians and the healthcare system.
SUMMARY
There are numerous opportunities to significantly lessen the disparities in kidney transplantation for AAs through the following measures: the adoption of new care and patient engagement models that include education, enhanced practice-level cultural sensitivity, and timely referral as well as increased research on the impact of the environment on genetic risk, and implementation of new transplantation-related policies. Key Messages: This systematic review describes pretransplant concerns related to access to kidney transplantation, posttransplant complications, and policy interventions to address the challenging issues associated with kidney transplantation in AAs.
背景
需要接受肾移植的非裔美国人（AA）在获得医疗保健方面仍然存在持续的挑战，而这些挑战在全国范围内尚未得到解决。这种医疗保健差距是多方面的：源于适合 AA 的有限的肾脏供体；护理协调不一致和风险因素控制不佳；社会决定因素、低社会经济地位、获得医疗保健的机会减少；以及对临床医生和医疗保健系统的不信任。
总结
通过以下措施，可以为 AA 提供显著减少肾移植差异的机会：采用新的护理和患者参与模式，包括教育、增强实践层面的文化敏感性以及及时转介，以及增加对环境对遗传风险影响的研究，以及实施新的与移植相关的政策。
关键信息
本系统评价描述了与接受肾移植相关的移植前问题、移植后并发症以及解决与 AA 肾移植相关的挑战性问题的政策干预措施。
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