Chen Mei-Fang, Yeh Mei-Ling
MSN, RN, Deputy Director, Department of Nursing, Far Eastern Memorial Hospital, and Doctoral Candidate, School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
PhD, DMS, RN, FAAN, Distinguished Professor, School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
Hu Li Za Zhi. 2024 Oct;71(5):96-103. doi: 10.6224/JN.202410_71(5).12.
Healthcare systems must embody equity, diversity, and inclusion (EDI) and, in the event of unfairness, appropriate policies / countermeasures should be enacted. The healthcare system response to the COVID-19 pandemic not only highlighted how socioeconomic disparities affect mortality risk but also posed significant challenges to the successful practice of EDI in healthcare. In light of this, this article was written to provide an overview of EDI, analyze the international efforts to promote it, and suggest strategies for promoting EDI in infectious disease healthcare using COVID-19 as an example. In healthcare settings, equity centers on ensuring patients receive fair treatment regardless of race, gender, age, or socioeconomic status; diversity centers on healthcare providers understanding the uniqueness of patients from different cultural backgrounds and the health barriers they face; and inclusion centers on ensuring patients are treated with respect and given the attention they deserve. During pandemics, social determinants of health (SDOH) greatly impact patient health outcomes and hinder the practice of EDI. Reflecting on the impact of COVID-19, healthcare systems can actively apply EDI in clinical practice to provide to all patients equitable access to healthcare opportunities and outcomes. Practical strategies include establishing EDI committees within healthcare systems, monitoring relevant data, conducting staff training, and continuously addressing the SDOH and needs of marginalized groups to achieve EDI in healthcare.
医疗保健系统必须体现公平、多样性和包容性(EDI),如果出现不公平现象,应制定适当的政策/对策。医疗保健系统对新冠疫情的应对不仅凸显了社会经济差距如何影响死亡风险,也给医疗保健领域成功践行EDI带来了重大挑战。鉴于此,撰写本文旨在概述EDI,分析国际上为促进EDI所做的努力,并以新冠疫情为例,提出在传染病医疗保健中促进EDI的策略。在医疗环境中,公平的核心是确保患者无论种族、性别、年龄或社会经济地位如何,都能得到公平对待;多样性的核心是医疗保健提供者理解来自不同文化背景患者的独特性以及他们所面临的健康障碍;包容性的核心是确保患者得到尊重并获得应有的关注。在疫情期间,健康的社会决定因素(SDOH)对患者健康结果有很大影响,并阻碍EDI的践行。反思新冠疫情的影响,医疗保健系统可以在临床实践中积极应用EDI,为所有患者提供公平的医疗保健机会和结果。实际策略包括在医疗保健系统内设立EDI委员会、监测相关数据、开展员工培训,以及持续关注SDOH和边缘化群体的需求,以在医疗保健领域实现EDI。