Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas.
Department of Emergency Medicine, University of California-Davis, Sacramento, California.
J Emerg Med. 2023 Jul;65(1):e60-e65. doi: 10.1016/j.jemermed.2023.03.063. Epub 2023 Mar 17.
Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.
The aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.
Current quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist.
Quality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level.
急诊医学（EM）中的质量措施旨在规范和改进护理。由于缺乏对性别差异的考虑，其发展受到限制。研究表明，性别差异会影响临床护理和治疗。需要纳入性别差异，以制定对所有人公平的 EM 质量措施。
本综述旨在简要介绍 EM 质量措施的历史，以及在其制定过程中考虑基于性别的证据的价值，以确保公平性，以急性心肌梗死（AMI）为例。
目前与 AMI 相关的质量措施，如心电图时间和经皮冠状动脉介入治疗的门球时间，在按性别分层时可能存在重要且可改变的差异。即使出现 AMI 的症状和体征，女性的诊断和治疗时间也会延迟。很少有研究考虑干预措施来减轻这些差异。然而，现有数据表明，通过实施质量控制检查表等策略，可以最大限度地减少基于性别的差异。
质量措施的创建是为了提供高质量、基于证据和标准化的护理，但如果不包括性别指标，它们可能无法将护理提升到公平的水平。
