UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California
Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California.
Ann Fam Med. 2022 Jul-Aug;20(4):362-367. doi: 10.1370/afm.2823.
In the wake of the racial injustices laid bare in 2020, on top of centuries of systemic racism, it is clear we need actionable strategies to fundamentally restructure health care systems to achieve racial/ethnic health equity. This paper outlines the pillars of a health equity framework from the Institute for Healthcare Improvement, overlaying a concrete example of telemedicine equity. Telemedicine is a particularly relevant and important topic, given the growing evidence of disparities in uptake by racial/ethnic, linguistic, and socioeconomic groups in the United States during the COVID-19 pandemic, as well as the new standard of care that telemedicine represents post-pandemic. We present approaches for telemedicine equity across the domains of: (1) strategic priorities of a health care organization, (2) structures and processes to advance equity, (3) strategies to address multiple determinants of health, (4) elimination of institutional racism and oppression, and (5) meaningful partnerships with patients and communities.
在 2020 年暴露的种族不公正以及数百年的系统性种族主义之后，显然我们需要采取切实可行的策略，从根本上重构医疗保健系统，以实现种族/族裔健康公平。本文概述了改善医疗保健研究所的健康公平框架的支柱，其中涵盖了远程医疗公平的具体例子。鉴于在美国 COVID-19 大流行期间，不同种族/族裔、语言和社会经济群体在远程医疗使用率方面存在差异的证据不断增加，以及远程医疗在后疫情时代代表新的护理标准，远程医疗是一个特别相关和重要的话题。我们提出了在以下领域实现远程医疗公平的方法：（1）医疗保健组织的战略重点，（2）推进公平的结构和流程，（3）解决多种健康决定因素的策略，（4）消除制度性种族主义和压迫，以及（5）与患者和社区建立有意义的伙伴关系。
