School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, NSW, Australia.
School of Public Health, University of Sydney, Sydney, 2006, NSW, Australia.
Int J Equity Health. 2020 Jul 8;19(1):118. doi: 10.1186/s12939-020-01223-2.
Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient safety events occurring amongst ethnic minority consumers, which is critical for the development of relevant intervention approaches to enhance the safety of their care.
To establish how ethnic minority populations are conceptualised in the international literature, and the implications of this in shaping of our findings; the evidence of patient safety events arising among ethnic minority healthcare consumers internationally; and the individual, service and system factors that contribute to unsafe care.
A systematic review of five databases (MEDLINE, PUBMED, PsycINFO, EMBASE and CINAHL) were undertaken using subject headings (MeSH) and keywords to identify studies relevant to our objectives. Inclusion criteria were applied independently by two researchers. A narrative synthesis was undertaken due to heterogeneity of the study designs of included studies followed by a study appraisal process.
Forty-five studies were included in this review. Findings indicate that: (1) those from ethnic minority backgrounds were conceptualised variably; (2) people from ethnic minority backgrounds had higher rates of hospital acquired infections, complications, adverse drug events and dosing errors when compared to the wider population; and (3) factors including language proficiency, beliefs about illness and treatment, formal and informal interpreter use, consumer engagement, and interactions with health professionals contributed to increased risk of safety events amongst these populations.
Ethnic minority consumers may experience inequity in the safety of care and be at higher risk of patient safety events. Health services and systems must consider the individual, inter- and intra-ethnic variations in the nature of safety events to understand the where and how to invest resource to enhance equity in the safety of care.
This systematic review is registered with Research Registry: reviewregistry761.
迄今为止的证据表明，由于一系列社会文化因素，少数民族背景的患者在接受医疗保健的质量和安全性方面可能存在差异。尽管患者安全事件风险增加是主要关注点，但关于少数民族患者中发生的患者安全事件的性质和发生率的证据很少，这对于制定相关干预措施以提高其护理安全性至关重要。
确定国际文献中如何概念化少数民族人群，以及这对我们研究结果的影响；国际上少数民族医疗保健消费者中出现的患者安全事件的证据；以及导致不安全护理的个人、服务和系统因素。
使用主题词（MeSH）和关键词对五个数据库（MEDLINE、PUBMED、PsycINFO、EMBASE 和 CINAHL）进行了系统审查，以确定与我们的目标相关的研究。两名研究人员分别独立应用纳入标准。由于纳入研究的研究设计存在异质性，因此进行了叙述性综合分析，随后进行了研究评估过程。
本综述共纳入 45 项研究。研究结果表明：（1）少数民族背景的人被不同地概念化；（2）与更广泛的人群相比，少数民族背景的人发生医院获得性感染、并发症、药物不良反应和剂量错误的比率更高；（3）包括语言熟练程度、对疾病和治疗的信念、正式和非正式口译员的使用、消费者参与以及与卫生专业人员的互动在内的因素导致这些人群发生安全事件的风险增加。
少数民族消费者在护理安全性方面可能存在不公平现象，并且发生患者安全事件的风险更高。卫生服务和系统必须考虑安全事件性质的个体、族内和族际差异，以了解在哪里以及如何投入资源，以提高护理安全性方面的公平性。
本系统评价在 Research Registry 上注册：reviewregistry761。
