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产科和围产期的种族和民族差异。

Obstetric and perinatal racial and ethnic disparities.

机构信息

Weill Cornell Medicine/New York-Presbyterian Hospital, Department of Anesthesiology, New York, New York, USA.

出版信息

Curr Opin Anaesthesiol. 2022 Jun 1;35(3):260-266. doi: 10.1097/ACO.0000000000001133.

Abstract

PURPOSE OF REVIEW

Healthcare disparities are health differences that adversely affect disadvantaged populations. In the United States, research shows that women of color, in particular Black and Hispanic women and their offspring, experience disproportionately higher mortality, severe maternal morbidity, and neonatal morbidity and mortality. This review highlights recent population health sciences and comparative effectiveness research that discuss racial and ethnic disparities in maternal and perinatal outcomes.

RECENT FINDINGS

Epidemiological research confirms the presence of maternal and neonatal disparities in national and multistate database analysis. These disparities are associated with geographical variations, hospital characteristics and practice patterns, and patient demographics and comorbidities. Proposed solutions include expanded perinatal insurance coverage, increased maternal healthcare public funding, and quality improvement initiatives/efforts that promote healthcare protocols and practice standardization.

SUMMARY

Obstetrical healthcare disparities are persistent, prevalent, and complex and are associated with systemic racism and social determinants of health. Some of the excess disparity gap can be explained through community-, hospital-, provider-, and patient-level factors. Providers and healthcare organizations should be mindful of these disparities and strive to promote healthcare justice and patient equity. Several solutions provide promise in closing this gap, but much effort remains.

摘要

目的综述

医疗保健差异是指对弱势群体产生不利影响的健康差异。在美国,研究表明,有色人种妇女,尤其是黑人和西班牙裔妇女及其后代,其死亡率、严重产妇发病率以及新生儿发病率和死亡率过高。本综述重点介绍了近期人口健康科学和比较效果研究,讨论了孕产妇和围产期结局方面的种族和民族差异。

最近的发现

流行病学研究证实,在国家和多州数据库分析中存在孕产妇和新生儿差异。这些差异与地理差异、医院特征和实践模式以及患者人口统计学特征和合并症有关。提出的解决方案包括扩大围产期保险覆盖范围、增加孕产妇保健公共资金,以及通过促进医疗保健协议和实践标准化的质量改进举措/努力。

总结

产科医疗保健差异持续存在、普遍存在且复杂,并与系统性种族主义和健康的社会决定因素有关。通过社区、医院、提供者和患者层面的因素可以解释部分过度差异。提供者和医疗保健组织应注意这些差异,并努力促进医疗保健公正和患者公平。一些解决方案有望缩小这一差距,但仍需做出很多努力。

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