Fox Ellen, Danis Marion, Tarzian Anita J, Duke Christopher C
Altarum Institute.
Fox Ethics Consulting.
Am J Bioeth. 2022 Apr;22(4):5-18. doi: 10.1080/15265161.2021.1893547. Epub 2021 Mar 26.
A 1999-2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to "best informants" in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC.
1999 - 2000年一项针对美国医院的全国性研究引发了对伦理咨询（EC）实践的担忧，并推动了改进工作。为评估自2000年以来实践有何变化，我们对美国600家综合医院分层随机样本中的“最佳信息提供者”进行了一项包含105个项目的调查。这篇主要文章详细介绍了整个研究的方法，然后聚焦于先前研究中的16个项目。与2000年相比，每年进行的病例咨询估计数量增长了94%，达到68,000例。每家医院咨询的中位数数量保持在3例不变，但床位400张及以上的医院咨询数量增加了一倍多。伦理咨询从业者的教育水平没有变化，而对其伦理咨询服务进行正式评估的医院比例从28.0%降至19.1%。自先前研究以来，大型教学医院与小型非教学医院之间的差距扩大了。我们建议将未来的改进工作目标指向那些当前伦理咨询方法无法满足需求的医院。
