From the Division of Anesthesiology, Sedation and Perioperative Medicine, Children's National Hospital-George Washington University, Washington, DC.
Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine at the University of Southern California, Spatial Sciences Institute at the University of Southern California, Los Angeles, California.
Anesth Analg. 2022 Jun 1;134(6):1175-1184. doi: 10.1213/ANE.0000000000005937. Epub 2022 Feb 2.
Anesthesiology and anesthesiologists have a tremendous opportunity and responsibility to eliminate health disparities and to achieve health equity. We thus examine health disparity and health equity through the lens of anesthesiology and the perspective of anesthesiologists. In this paper, we define health disparity and health care disparities and provide tangible, representative examples of the latter in the practice of anesthesiology. We define health equity, primarily as the desired antithesis of health disparity. Finally, we propose a framework for anesthesiologists, working toward mitigating health disparity and health care disparities, advancing health equity, and documenting improvements in health care access and health outcomes. This multilevel and interdependent framework includes the perspectives of the patient, clinician, group or department, health care system, and professional societies, including medical journals. We specifically focus on the interrelated roles of social identity and social determinants of health in health outcomes. We explore the foundational role that clinical informatics and valid data collection on race and ethnicity have in achieving health equity. Our ability to ensure patient safety by considering these additional patient-specific factors that affect clinical outcomes throughout the perioperative period could substantially reduce health disparities. Finally, we explore the role of medical journals and their editorial boards in ameliorating health disparities and advancing health equity.
麻醉学和麻醉师有巨大的机会和责任来消除健康差异，实现健康公平。因此，我们通过麻醉学的视角和麻醉师的观点来审视健康差异和健康公平。在本文中，我们定义了健康差异和医疗保健差异，并提供了麻醉学实践中后者的具体、有代表性的例子。我们将健康公平主要定义为健康差异的理想对立面。最后，我们为麻醉师提出了一个框架，旨在减轻健康差异和医疗保健差异，促进健康公平，并记录医疗保健获取和健康结果的改善。这个多层次和相互依存的框架包括患者、临床医生、团体或部门、医疗保健系统以及专业协会（包括医学期刊）的观点。我们特别关注社会认同和健康的社会决定因素在健康结果中的相互关联作用。我们探讨了临床信息学和关于种族和民族的有效数据收集在实现健康公平方面的基础作用。通过考虑影响围手术期临床结果的这些额外的患者特定因素来确保患者安全，可能会大大减少健康差异。最后，我们探讨了医学期刊及其编辑委员会在改善健康差异和促进健康公平方面的作用。
