Gemson D H, Elinson J, Messeri P
Columbia University School of Public Health, Division of Sociomedical Sciences, New York, New York 10032.
J Community Health. 1988 Spring;13(1):53-64. doi: 10.1007/BF01321480.
A telephone survey of 120 randomly selected primary care physicians in New York City was completed in October, 1984 (response rate = 90%) concerning physicians' recommendations for health promotion and disease prevention. Responses from physicians with 50% or more Black and Hispanic patients were compared with responses from physicians with 50% or more White patients. The former were found to be less likely to follow guidelines from nationally recognized organizations for health promotion and disease prevention, although they were just as likely to value the importance of prevention in primary care. For example, physicians with predominantly Black and Hispanic patient populations were significantly less likely to recommend screening mammography (7% versus 23%) or recommend influenza vaccination for patients 65 or older (48% versus 74%) when compared with physicians with predominantly White patient populations. Factors that appeared to contribute to the difference in prevention practice patterns include physician training and education, the socioeconomic status of the patients, and the time physicians spend with patients. Differences in quality of preventive care provided to minority patients may be an additional factor in the disparity between the health status of White and non-White Americans.
1984年10月，针对纽约市120名随机抽取的初级保健医生完成了一项电话调查（回复率 = 90%），内容涉及医生对健康促进和疾病预防的建议。将拥有50%或更多黑人和西班牙裔患者的医生的回复与拥有50%或更多白人患者的医生的回复进行了比较。结果发现，前者不太可能遵循国家认可的健康促进和疾病预防组织的指导方针，尽管他们同样重视预防在初级保健中的重要性。例如，与主要为白人患者群体的医生相比，主要为黑人和西班牙裔患者群体的医生推荐乳腺钼靶筛查的可能性显著更低（7%对23%），或者为65岁及以上患者推荐流感疫苗接种的可能性也更低（48%对74%）。似乎导致预防实践模式差异的因素包括医生培训和教育、患者的社会经济地位以及医生与患者相处的时间。为少数族裔患者提供的预防保健质量差异可能是美国白人和非白人健康状况差距的另一个因素。
