Kaiksow Farah A, Brendel Marina, Hubbard Colin C, Lee Tiffany, Chia David, Brooks Katherine, Ruhnke Gregory W, Raffel Katie E, Goyal Abhishek, Kantor Molly A, Helminski A Shams, Alday Angela, Astik Gopi J, Barish Peter, Schnipper Jeffrey L, Auerbach Andrew D
Department of Medicine, Division of Hospital Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
J Hosp Med. 2025 Jul;20(7):727-730. doi: 10.1002/jhm.13574. Epub 2024 Dec 12.
Patients who reside in areas of high neighborhood disadvantage have poorer health outcomes; the mechanisms for this disparity are complex. We sought to determine if there was an association between neighborhood disadvantage and diagnostic error among a cohort of adult inpatients who experienced either an ICU transfer or in-hospital death. Using a sample of 527 patients from seven geographically diverse academic medical systems, we compared diagnostic error rates to patients' neighborhood disadvantage levels as measured by the Area Deprivation Index, a validated composite measure of socioeconomic status. In contrast to previous studies that found differences in hospital care based on socioeconomic status, we found no difference in diagnostic error rate between patients based on neighborhood disadvantage. Once a patient reaches the hospital, their risk of diagnostic error is not related to the neighborhood in which they live.
居住在社区劣势程度高的地区的患者健康状况较差；这种差异的机制很复杂。我们试图确定在经历重症监护病房（ICU）转诊或院内死亡的成年住院患者队列中，社区劣势与诊断错误之间是否存在关联。我们从七个地理位置不同的学术医疗系统中选取了527名患者作为样本，将诊断错误率与通过地区剥夺指数衡量的患者社区劣势水平进行了比较，地区剥夺指数是一种经过验证的社会经济地位综合衡量指标。与之前发现基于社会经济地位的医院护理存在差异的研究不同，我们发现基于社区劣势的患者之间诊断错误率没有差异。一旦患者入院，他们发生诊断错误的风险与居住社区无关。
