Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Biostatistical Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Am J Perinatol. 2024 May;41(S 01):e318-e323. doi: 10.1055/s-0042-1755548. Epub 2022 Sep 2.
We determine whether racial concordance between postpartum patients and obstetric providers (dyads) impacts the perception of quality of care among people undergoing intrapartum obstetrical procedures.
This is a prospective cohort study of postpartum people who underwent operative vaginal or cesarean deliveries in the second stage of labor. Participants were asked to identify the race of their primary provider and complete the Interpersonal Processes of Care (IPC) survey, which assesses communication, patient-centered decision-making, and interpersonal style. The association of participant-identified patient-provider racial concordance with IPC scores was determined. The primary outcome was the IPC subdomain related to discrimination, and secondary outcomes included other IPC subdomains and IPC results by participant racial identity (Black, LatinX vs. White). Sociodemographic and biomedical data were extracted from the medical record. Bivariable analyses were performed.
Of 168 patients who were approached, 107 (63.6%) agreed to participate and 87 (81.3%) completed the survey. The majority (=49) identified a racially discordant provider. Participants in racially concordant dyads were more likely to be older, White, use English as a primary language, complete a higher degree of education, and have a higher household income when compared with racially discordant dyads. Intrapartum outcomes were not significantly different between groups. Median IPC subtest scores were not significantly different between groups or between racial/ethnic identities.
There were no significant differences in perceptions of IPC between racially concordant versus discordant dyads. However, there is an ongoing need to further clarify measures of quality of care in high-acuity obstetrical situations to remediate ongoing racial and ethnic disparities in adverse health outcomes.
· Racial concordance between patient and clinician has been associated with improved quality of care.. · There are limited data on racial concordance and perceptions of operative obstetrical care (e.g., operative vaginal delivery).. · Racial concordance was not associated with differences in patient-perceived quality of care associated with operative obstetrics..
我们确定产后患者和产科医务人员（医患二人组）之间的种族一致性是否会影响接受产时产科手术的人群对护理质量的感知。
这是一项前瞻性队列研究，纳入在第二产程行阴道助产或剖宫产的产后患者。参与者被要求识别其主要医务人员的种族，并完成人际护理过程（IPC）调查，该调查评估沟通、以患者为中心的决策制定和人际风格。确定参与者识别的医患种族一致性与 IPC 评分的相关性。主要结局是与歧视相关的 IPC 亚域，次要结局包括其他 IPC 亚域和按参与者种族身份（黑人、拉丁裔与白人）划分的 IPC 结果。从病历中提取社会人口统计学和生物医学数据。进行了双变量分析。
在 168 名被接触的患者中，有 107 名（63.6%）同意参与，87 名（81.3%）完成了调查。大多数（=49 名）识别出种族不一致的提供者。与种族不一致的医患二人组相比，种族一致的医患二人组的参与者更有可能年龄较大、为白人、将英语作为主要语言、受教育程度更高、家庭收入更高。两组间产时结局无显著差异。组间或种族/民族身份间 IPC 亚测试评分无显著差异。
种族一致的医患二人组与种族不一致的医患二人组之间 IPC 的感知无显著差异。然而，仍需进一步明确在高风险产科情况下护理质量的衡量标准，以纠正不良健康结局方面持续存在的种族和民族差异。
· 患者与临床医生之间的种族一致性与改善护理质量相关。· 关于种族一致性和对产科手术护理的感知（例如，阴道助产）的数据有限。· 种族一致性与与产科手术相关的患者感知的护理质量差异无关。
