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心脏重症监护中的健康差异:理解不平等、障碍以及实现公平获取和改善结局的途径。

Health Disparities in Cardiac Critical Care: Understanding Inequities, Barriers, and Pathways Toward Equitable Access and Enhanced Outcomes.

作者信息

Abouzid Mohamed R, Kamel Ibrahim, Elkhawas Ibrahim, Rezk Amro, Esteghamati Sadaf, Nwaukwa Chima C

机构信息

Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, USA.

Internal Medicine, Tufts Medical Center, Boston, USA.

出版信息

Cureus. 2024 Jul 9;16(7):e64151. doi: 10.7759/cureus.64151. eCollection 2024 Jul.

Abstract

Health disparities in cardiac critical care continue to pose significant challenges in achieving equitable access and outcomes for diverse populations. This literature review examines the disparities in access to and outcomes of cardiac critical care interventions across different populations, identifies barriers contributing to these disparities, and explores strategies to address them. A literature review was conducted by searching electronic databases for relevant articles published between January 2000 and May 2023. Studies focusing on health disparities in cardiac critical care, access to interventions, outcomes, and equity were included. Data were extracted and synthesized using a narrative approach. Disparities in access to cardiac critical care interventions were identified, including socioeconomic factors, lack of health insurance, geographic barriers, racial and ethnic disparities, language and cultural barriers, limited health literacy, and lack of awareness and education. These barriers led to delayed diagnoses, suboptimal utilization of interventions, and limited access to specialized cardiac care. Disparities in outcomes were also observed, with certain populations experiencing worse clinical outcomes and higher morbidity and mortality rates. This review emphasizes the existence of disparities in cardiac critical care and emphasizes the necessity for interventions to address these disparities. Specific strategies should concentrate on enhancing healthcare access, diminishing financial obstacles, expanding health insurance coverage, fostering patient-centered approaches, and harnessing telemedicine and technology. Collaborative efforts among policymakers, healthcare providers, researchers, and patient advocates are vital to advocate for policy changes and implement evidence-based interventions that foster equitable care. Future research should prioritize longitudinal studies, implementation science, patient engagement, global perspectives, and rigorous evaluation of intervention strategies to advance our knowledge and guide endeavors in reducing health disparities in cardiac critical care.

摘要

心脏重症监护中的健康差异在为不同人群实现公平的医疗服务可及性和治疗结果方面仍然构成重大挑战。这篇文献综述探讨了不同人群在心脏重症监护干预措施的可及性和治疗结果方面的差异,确定了导致这些差异的障碍,并探索了解决这些差异的策略。通过检索电子数据库,对2000年1月至2023年5月期间发表的相关文章进行了文献综述。纳入了关注心脏重症监护中的健康差异、干预措施的可及性、治疗结果和公平性的研究。采用叙述性方法提取和综合数据。确定了心脏重症监护干预措施可及性方面的差异,包括社会经济因素、缺乏医疗保险、地理障碍、种族和族裔差异、语言和文化障碍、健康素养有限以及缺乏认识和教育。这些障碍导致诊断延迟、干预措施利用不足以及获得专科心脏护理的机会有限。还观察到了治疗结果的差异,某些人群的临床结果较差,发病率和死亡率较高。本综述强调了心脏重症监护中差异的存在,并强调了采取干预措施解决这些差异的必要性。具体策略应集中在增加医疗服务可及性、减少经济障碍、扩大医疗保险覆盖范围、采用以患者为中心的方法以及利用远程医疗和技术。政策制定者、医疗服务提供者、研究人员和患者倡导者之间的合作努力对于倡导政策变革和实施促进公平护理的循证干预措施至关重要。未来的研究应优先进行纵向研究、实施科学、患者参与、全球视角以及对干预策略进行严格评估,以增进我们的知识并指导减少心脏重症监护中健康差异的努力。

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