Department of Surgery, University of Michigan, Ann Arbor, MI.
Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, MI.
Ann Surg. 2023 Aug 1;278(2):184-192. doi: 10.1097/SLA.0000000000005858. Epub 2023 Mar 30.
Racial and ethnic inequities in surgical care in the United States are well documented. Less is understood about evidence-based interventions that improve surgical care and reduce or eliminate inequities. In this review, we discuss effective patient, surgeon, community, health care system, policy, and multi-level interventions to reduce inequities and identifying gaps in intervention-based research.
Evidenced-based interventions to reduce racial and ethnic inequities in surgical care are key to achieving surgical equity. Surgeons, surgical trainees, researchers, and policy makers should be aware of the evidence-based interventions known to reduce racial and ethnic disparities in surgical care for prioritization of resource allocation and implementation. Future research is needed to assess interventions effectiveness in the reduction of disparities and patient-reported measures.
We searched PubMed database for English-language studies published from January 2012 through June 2022 to assess interventions to reduce or eliminate racial and ethnic disparities in surgical care. A narrative review of existing literature was performed identifying interventions that have been associated with reduction in racial and ethnic disparities in surgical care.
Achieving surgical equity will require implementing evidenced-based interventions to improve quality for racial and ethnic minorities. Moving beyond description toward elimination of racial and ethnic inequities in surgical care will require prioritizing funding of intervention-based research, utilization of implementation science and community based-participatory research methodology, and principles of learning health systems.
美国外科护理中的种族和民族不平等现象已有大量记载。对于能够改善外科护理并减少或消除不平等现象的循证干预措施,人们的了解较少。在这篇综述中,我们讨论了有效改善外科护理的患者、外科医生、社区、医疗保健系统、政策和多层次干预措施,以减少不平等现象,并确定基于干预的研究中的差距。
减少外科护理中种族和民族不平等的循证干预措施是实现外科公平的关键。外科医生、外科受训者、研究人员和政策制定者应该了解已知可减少外科护理中种族和民族差异的循证干预措施,以便优先分配资源和实施。需要进一步研究来评估干预措施在减少差异和患者报告的衡量指标方面的有效性。
我们在 PubMed 数据库中搜索了 2012 年 1 月至 2022 年 6 月期间发表的英文研究,以评估减少或消除外科护理中种族和民族差异的干预措施。对现有文献进行了叙述性综述,确定了与减少外科护理中种族和民族差异相关的干预措施。
实现外科公平将需要实施循证干预措施,以提高少数民族的护理质量。要超越描述,消除外科护理中的种族和民族不平等现象,就需要优先为基于干预的研究提供资金,利用实施科学和社区参与式研究方法,并遵循学习型卫生系统的原则。