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医疗服务提供者与患者种族匹配度和产后护理接受情况之间的关系

The Relationship Between Provider and Patient Racial Concordance and Receipt of Postpartum Care.

作者信息

Rattan Jesse, Bartlett T Robin, Blanchard Christina, Tipre Meghan, Amiri Azita, Baskin Monica L, Sinkey Rachel, Turan Janet M

机构信息

Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Sep 13. doi: 10.1007/s40615-024-02164-0.

Abstract

Access to postpartum care (PPC) varies in the US and little data exists about whether patient factors may influence receipt of care. Our study aimed to assess the effect of provider-patient racial concordance on Black patients' receipt of PPC. We conducted a cross-sectional study analyzing over 24,000 electronic health records of childbirth hospitalizations at a large academic medical center  in Alabama from January 2014 to March 2020. The primary outcome variable was whether a Black patient with a childbirth hospitalization had any type of PPC visit within 12 weeks after childbirth. We used a generalized estimating equation (GEE) logistic regression model to assess the relationship between provider-patient racial concordance and receipt of PPC. Black patients with Black main providers of prenatal or childbirth care had significantly higher adjusted odds of receiving PPC (adj. OR 2.26, 95% CI 1.65-3.09, p < .001) compared to Black patients with non-Black providers. White patients who had White providers did not have statistically significantly different odds of receiving PPC compared to those with non-White providers after adjustment (adj. OR 0.88, 95% CI 0.68-1.14). Although these results should be interpreted with caution given the low number of Black providers in this sample, our findings suggest that in one hospital system in Alabama, Black birthing people with a racially concordant main prenatal and delivery care provider may have an increased likelihood of getting critical PPC follow-up.

摘要

在美国,获得产后护理(PPC)的机会各不相同,而且关于患者因素是否会影响护理的接受情况,相关数据很少。我们的研究旨在评估医患种族匹配对黑人患者接受PPC的影响。我们进行了一项横断面研究,分析了2014年1月至2020年3月期间阿拉巴马州一家大型学术医疗中心超过24000份分娩住院电子健康记录。主要结局变量是分娩住院的黑人患者在产后12周内是否进行过任何类型的PPC就诊。我们使用广义估计方程(GEE)逻辑回归模型来评估医患种族匹配与接受PPC之间的关系。与由非黑人提供者护理的黑人患者相比,由黑人提供产前或分娩护理的主要提供者护理的黑人患者接受PPC的调整后几率显著更高(调整后比值比2.26,95%置信区间1.65 - 3.09,p < 0.001)。调整后,与由非白人提供者护理的白人患者相比,由白人提供者护理的白人患者接受PPC的几率在统计学上没有显著差异(调整后比值比0.88,95%置信区间0.68 - 1.14)。尽管鉴于该样本中黑人提供者数量较少,这些结果应谨慎解读,但我们的研究结果表明,在阿拉巴马州的一个医院系统中,拥有种族匹配的主要产前和分娩护理提供者的黑人分娩者可能更有可能获得关键的PPC随访。

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本文引用的文献

10
Postpartum Visit Attendance in the United States: A Systematic Review.美国的产后访视参与情况:一项系统评价。
Womens Health Issues. 2022 Jul-Aug;32(4):369-375. doi: 10.1016/j.whi.2022.02.002. Epub 2022 Mar 15.

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