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骨科手术中的患者差异与医疗服务提供者多样性:一种复杂的关系。

Patient Disparities and Provider Diversity in Orthopaedic Surgery: A Complex Relationship.

作者信息

Wright Melissa A, Murthi Anand M, Aleem Alexander, Zmistowski Benjamin

机构信息

From the Department of Orthopedic Surgery, Shoulder and Elbow Service, MedStar Union Memorial Hospital, Baltimore, MD (Wright and Murthi), the Department of Orthopedic Surgery, Georgetown University School of Medicine, Washington, DC (Wright and Murthi), the Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO (Aleem and Zmistowski).

出版信息

J Am Acad Orthop Surg. 2023 Feb 1;31(3):132-139. doi: 10.5435/JAAOS-D-22-00410. Epub 2022 Dec 22.

Abstract

Disparities in the access to, utilization of, and outcomes after orthopaedic surgery are a notable problem in the field that limits patients' ability to access the highest level of care and achieve optimal outcomes. Disparities exist based on numerous sociodemographic factors, with sex and race/ethnicity being two of the most well-studied factors linked to disparities in orthopaedic care. These disparities cross all subspecialties and tend to negatively affect women and racial/ethnic minorities. The increased recognition of the disparities in orthopaedic care has been paralleled by an increased recognition of the lack of diversity among orthopaedic surgeons. Although efforts are being made to improve the representation of women and underrepresented minorities among orthopaedic surgeons, the numbers, particularly of racial and ethnic minorities, show little improvement. The lack of gender and racial diversity among orthopaedic surgeons may be one of many factors related to the gender and racial disparities seen in orthopaedic care. Patients may prefer a provider that they can better identify with and that may affect care. Orthopaedic surgery as a specialty must continue to work to foster an inclusive environment and make concerted efforts to improve diversity through the recruitment of women and underrepresented minorities, among others, for the benefit of patients, surgeons, and the continued growth of the field as a whole.

摘要

骨科手术在获得医疗服务、医疗利用以及术后结果方面存在的差异是该领域一个显著的问题,它限制了患者获得最高水平医疗服务并实现最佳治疗效果的能力。基于众多社会人口学因素存在差异,性别和种族/族裔是与骨科医疗差异相关的两个研究最为充分的因素。这些差异贯穿所有亚专业,并且往往对女性和少数种族/族裔产生负面影响。对骨科医疗差异认识的增加,与对骨科医生缺乏多样性认识的增加是并行的。尽管正在努力提高女性和在骨科医生中代表性不足的少数群体的比例,但数量,尤其是种族和族裔少数群体的数量,几乎没有改善。骨科医生中缺乏性别和种族多样性可能是骨科医疗中出现的性别和种族差异的众多相关因素之一。患者可能更喜欢他们能更好认同的医疗服务提供者,而这可能会影响医疗护理。作为一个专业领域,骨科手术必须继续努力营造一个包容的环境,并通过招募女性和代表性不足的少数群体等方式,共同努力提高多样性,以造福患者、外科医生以及整个领域的持续发展。

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