Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
J Natl Med Assoc. 2021 Oct;113(5):504-514. doi: 10.1016/j.jnma.2021.03.007. Epub 2021 Apr 18.
Healthcare disparities negatively impact patient health outcomes; addressing disparities could improve quality of life and decrease overall healthcare cost. The National Ambulatory Medical Care Survey (NAMCS) is an objective and reliable source for collecting information on United States (U.S.) ambulatory medical care service visits and may be a useful tool for identifying potential disparities in care.
The purpose of this literature review is to describe studies utilizing NAMCS to capture U.S. healthcare disparities.
PubMed was searched for scientific articles that utilized NAMCS to determine health disparities in the U.S. The keywords queried included "NAMCS" or "National Ambulatory Medical Care Survey" and "disparity" or "disparities" as a pair or additionally paired with one of the following: "race", "ethnicity", "age", "gender", "geography", or "insurance".
66 studies were found that incorporated NAMCS data from 1980-2016 into their methods to measure outcomes relating to health disparities. Disparities were found in the following categories: race/ethnicity, geographic location, age, insurance type, gender, specialist care versus primary care, body habitus, and preexisting conditions affecting patient outcomes. Disparities were identified in pain management, neurology, dermatology, psychiatry, patient communication access, and non-specialty specific or primary care visits related to disease conditions, screening, and treatment plans.
Only PubMed was utilized as a search engine and may not encompass all studies on NAMCS and health disparities. NAMCS is a cross-sectional database and does not allow for longitudinal analyses.
NAMCS may be an underused tool given the limited number of articles that identify health disparities using it. Research studies utilizing NAMCS may identify potential disparities ultimately leading to better healthcare outcomes.
医疗保健差异对患者的健康结果产生负面影响；解决差异可以提高生活质量并降低整体医疗保健成本。国家门诊医疗保健调查（NAMCS）是收集有关美国门诊医疗保健服务访问信息的客观可靠来源，并且可能是识别护理中潜在差异的有用工具。
本文献综述的目的是描述利用 NAMCS 来捕捉美国医疗保健差异的研究。
在 PubMed 上搜索利用 NAMCS 来确定美国健康差异的科学文章。查询的关键词包括“NAMCS”或“National Ambulatory Medical Care Survey”和“disparity”或“disparities”作为一对，或者另外与以下之一配对：“race”，“ethnicity”，“age”，“gender”，“geography”或“insurance”。
共发现 66 项研究，这些研究将 NAMCS 数据纳入其方法中，以衡量与健康差异相关的结果。在以下类别中发现了差异：种族/民族，地理位置，年龄，保险类型，性别，专科护理与初级护理，体型和影响患者预后的现有疾病。在疼痛管理，神经病学，皮肤病学，精神病学，患者沟通途径以及与疾病状况，筛查和治疗计划有关的非专科或初级保健就诊中，都发现了差异。
仅使用 PubMed 作为搜索引擎，可能无法涵盖所有关于 NAMCS 和健康差异的研究。NAMCS 是一个横断面数据库，不允许进行纵向分析。
考虑到利用 NAMCS 确定健康差异的文章数量有限，NAMCS 可能是一种未充分利用的工具。利用 NAMCS 的研究可能会发现潜在的差异，从而最终改善医疗保健结果。
