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美国不同种族和族裔的育龄非孕妇糖尿病患者对其医疗服务提供者的体验

Patient Experience with Their Health Care Provider Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus by Race and Ethnicity in the United States.

作者信息

Brown Kyrah K, Kindratt Tiffany B, Brannon Grace Ellen, Sankuratri Bala Yadu Vamsi, Boateng Godfred O

机构信息

Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA.

Department of Communication, University of Texas at Arlington, Arlington, Texas, USA.

出版信息

Womens Health Rep (New Rochelle). 2023 Jan 24;4(1):20-30. doi: 10.1089/whr.2022.0037. eCollection 2023.

Abstract

OBJECTIVES

The study objective was to investigate differences in patient experiences with health care providers among non-pregnant women of childbearing age with diabetes mellitus (DM) by race/ethnicity.

DESIGN

This study used cross-sectional data from the 2012-2018 Medical Expenditure Panel Survey. The sample was limited to women of childbearing age (18-45 years) who have ever been told they had diabetes ( = 763; weighted  = 903,670). The key independent variable was race/ethnicity. The variables of interest included patient experiences with health care in the past 12 months: patient-provider communication (PPC); patient-provider racial/ethnic concordance; patient-provider gender concordance; and satisfaction.

RESULTS

After adjusting for age, marital status, education, poverty level, health insurance, and perceived health status, non-Hispanic (NH) Black women had lower odds (adjusted odds ratio [aOR] = 0.04; 95% confidence interval [CI] = 0.01-0.11) of receiving care from a health care provider of the same race compared with NH white women. Similar results were found among Hispanic and NH women of other or multiple races. Hispanic women had lower odds (aOR = 0.18; 95% CI = 0.06-0.50) of seeing a health care provider of the same race/ethnicity compared with NH white women in adjusted models. There were no statistically significant differences in PPC, patient-provider gender concordance, and satisfaction with their health care provider among Hispanic, NH Black, or NH women of other or multiple races in comparison to NH White women.

CONCLUSION

There is a need to improve PPC quality and satisfaction in this patient population. Patient-provider racial/ethnic discordance among women of color with DM is concerning given the existing diabetes-related disparities. More research on women with DM is needed to inform and improve patient experience and health outcomes.

摘要

目的

本研究的目的是调查按种族/族裔划分的育龄非妊娠糖尿病(DM)女性患者与医疗服务提供者就医经历的差异。

设计

本研究使用了2012 - 2018年医疗支出面板调查的横断面数据。样本仅限于曾被告知患有糖尿病的育龄女性(18 - 45岁)(n = 763;加权n = 903,670)。关键自变量是种族/族裔。感兴趣的变量包括过去12个月内患者与医疗服务的就医经历:患者与提供者沟通(PPC);患者与提供者的种族/族裔一致性;患者与提供者的性别一致性;以及满意度。

结果

在对年龄、婚姻状况、教育程度、贫困水平、医疗保险和自我感知健康状况进行调整后,与非西班牙裔(NH)白人女性相比,非西班牙裔黑人女性接受同一种族医疗服务提供者治疗的几率较低(调整后的优势比[aOR] = 0.04;95%置信区间[CI] = 0.01 - 0.11)。在西班牙裔以及其他或多种族的NH女性中也发现了类似结果。在调整模型中,与NH白人女性相比,西班牙裔女性见到同一种族/族裔医疗服务提供者的几率较低(aOR = 0.18;95% CI = 0.06 - 0.50)。与NH白人女性相比,西班牙裔、NH黑人或其他或多种族的NH女性在PPC、患者与提供者性别一致性以及对医疗服务提供者的满意度方面没有统计学上的显著差异。

结论

有必要改善这一患者群体的PPC质量和满意度。鉴于现有的糖尿病相关差异,患有DM的有色人种女性患者与提供者之间的种族/族裔不一致令人担忧。需要对患有DM的女性进行更多研究,以为改善患者就医体验和健康结果提供信息。

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