Health Management, School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Clinical Governance Unit, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.
Child Care Health Dev. 2020 Sep;46(5):644-649. doi: 10.1111/cch.12787. Epub 2020 Jun 5.
Children with intellectual disability are susceptible to poor experiences of care and treatment outcomes, and this may compound existing health inequities. Evidence to date indicates three priority areas that must be addressed in order to reduce these inequities in the safety and quality of care for children with intellectual disability. Firstly, we need reliable methods to identify children with intellectual disability so that healthcare organizations understand their needs. Secondly, we need to develop quality metrics that can assess care quality and unwarranted care variation for children with intellectual disability in hospital. Finally, for a comprehensive understanding of the safety and quality of care for these children, and how to improve, it is critical that healthcare organizations partner with parents/carers and enable children with intellectual disability to voice their experiences of care. Children with intellectual disability have higher healthcare utilization than their peers; yet, their voice is rarely sought to optimize the safety and quality of their healthcare experience. Patient experience narratives enhance our understanding of the genesis of adverse events. By addressing these priorities, children with intellectual disability will be identified, and health services will measure and understand the problematic and beneficial variations in care delivery and can then effectively partner with children and their parents/carers to address the inequities in care quality and create safer healthcare.
智障儿童容易遭受不良的护理体验和治疗结果，这可能会加剧现有的健康不平等现象。现有证据表明，为了减少智障儿童在护理安全和质量方面的这些不平等现象，必须解决三个优先领域。首先，我们需要可靠的方法来识别智障儿童，以便医疗保健组织了解他们的需求。其次，我们需要制定质量指标，以评估智障儿童在医院的护理质量和不必要的护理差异。最后，为了全面了解这些儿童的护理安全和质量，以及如何改进，医疗保健组织必须与家长/照顾者合作，并使智障儿童能够表达他们的护理体验。智障儿童的医疗保健利用率高于同龄人；然而，为了优化他们的医疗保健体验的安全性和质量，很少有人征求他们的意见。患者体验叙述增强了我们对不良事件起源的理解。通过解决这些优先事项，智障儿童将得到识别，卫生服务将衡量和了解护理提供方面的问题和有益的差异，然后可以与儿童及其家长/照顾者有效合作，解决护理质量方面的不平等问题，并创建更安全的医疗保健环境。
