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调查因受伤前往急救服务部门的少数族裔与英国白人之间差异的常规结果:利益相关者咨询。

Routine outcomes to investigate differences between ethnic minorities and White British people presenting to emergency services for injury: the stakeholder consultation.

作者信息

Baghdadi Fadi, Evans Bridie Angela, John Ann, Lloyd Adam, Lyons Ronan A, Naha Gargi, Porter Alison, Siriwardena Aloysius Niroshan, Snooks Helen, Watkins Alan, Williams Julia, Khanom Ashrafunnesa

机构信息

Medical School, Swansea University, Swansea, UK.

Research and Innovation Hub, Scottish Ambulance Service, Edinburgh, Scotland.

出版信息

Health Soc Care Deliv Res. 2024 Oct 2:1-9. doi: 10.3310/KTNH6788.

Abstract

INTRODUCTION

Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury.

OBJECTIVE

Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps.

METHOD

Clinicians, public contributors, researchers, people from the third sector, public health, healthcare inclusion were invited to join an online workshop to discuss routine outcomes.

RESULTS

Twenty participants attended the stakeholder consultation, with only one being a public contributor, a limitation. Eleven were from a minority ethnic background and seven were female. The integrated list of outcomes included 25 items, combining routine outcomes from the Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries protocol and literature ( = 17) with additional outcomes ( = 8). Notably, the initial list lacked provisions for safeguarding referrals and cases of treatment refusal, which were new additions. Safety concerns arose due to the lack of safeguarding referrals, treatment refusal and self-discharge. Factors such as pre-existing health conditions, injury location and experiences of discrimination were identified as possible influences on care quality and waiting times for ethnic minority patients.

CONCLUSION

Although the number of stakeholders taking part in our consultation was low, their participation identified outcomes not found in routine data, supporting the adoption of a mixed-methods approach to answer our research questions. A future consultation could look to include more public members and wider range of clinicians including those who work in safeguarding and rehabilitation services.

FUNDING

This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744.

摘要

引言

研究发现,在某些临床情况下,少数族裔人群与英国白人人群在医疗过程和结果方面存在差异,尽管研究结果不一。“了解少数族裔人群与伤害急救相关的服务使用情况”研究正在调查少数族裔人群与寻求伤害急救的英国白人在就诊表现、就医体验和健康结果方面的差异。

目的

我们的目标是与利益相关者进行磋商,以确定常规救护车和急诊科数据中可用的可衡量结果;评估现有结果指标对少数族裔人群和英国白人的适用性;并找出任何差距。

方法

邀请临床医生、公众参与者、研究人员、第三部门人员、公共卫生人员、医疗保健包容性方面的人员参加在线研讨会,讨论常规结果。

结果

20名参与者参加了利益相关者磋商,其中只有一名公众参与者,这是一个局限性。11人来自少数族裔背景,7人为女性。综合结果清单包括25项,将“了解少数族裔人群与伤害急救相关的服务使用情况”方案和文献中的常规结果(=17)与其他结果(=8)相结合。值得注意的是,最初的清单缺乏关于保障转介和拒绝治疗病例的规定,这些是新增内容。由于缺乏保障转介、拒绝治疗和自行出院的规定,出现了安全问题。诸如既往健康状况、受伤部位和歧视经历等因素被确定为可能影响少数族裔患者护理质量和等待时间的因素。

结论

尽管参与我们磋商的利益相关者数量较少,但他们的参与确定了常规数据中未发现的结果,支持采用混合方法来回答我们的研究问题。未来的磋商可能会考虑纳入更多公众成员和更广泛的临床医生,包括从事保障和康复服务的人员。

资金来源

本文介绍了由英国国家卫生与保健研究院(NIHR)卫生与社会保健交付研究计划资助的独立研究,资助编号为NIHR132744。

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