Department of Emergency Medicine, University of California, San Francisco.
Philip R. Lee Institute of Health Policy Studies, University of California, San Francisco.
Med. 2022 Feb 11;3(2):98-103. doi: 10.1016/j.medj.2022.01.006.
Drawing on evidence of socioeconomic disparities in emergency care, we show how structural discrimination is the most pervasive driver of these disparities, largely because of an inequitable distribution of healthcare services and unequal benefits derived from scientific advancement. We analyze how the market-based healthcare system in the U.S. has created a scenario in which the allocation of emergency care resources does not match community demand for emergency care, resulting in disproportionately poor access, treatment, and outcomes among historically underserved populations. Without fundamental reform, there is little hope for decreasing the health outcome gaps between the "haves" and "have-nots" in the United States.
借鉴紧急护理中社会经济差异的证据，我们展示了结构性歧视是造成这些差异的最普遍驱动因素，主要原因是医疗服务的不平等分配以及从科学进步中获得的不平等利益。我们分析了美国基于市场的医疗体系如何造成了一种情况，即紧急护理资源的分配与社区对紧急护理的需求不匹配，导致在历史上服务不足的人群中获得、治疗和结果的机会不成比例地减少。如果没有根本性的改革，美国“有”和“没有”之间的健康结果差距就很难缩小。
