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患者种族与医生表现:医疗质量、住院情况及住院时长。

Patient race and physician performances: quality of medical care, hospital admissions and hospital stays.

作者信息

Rhee S O, Lyons T F, Payne B C

出版信息

Med Care. 1979 Jul;17(7):737-47. doi: 10.1097/00005650-197907000-00004.

Abstract

The study has attempted to determine the extent of the relationship between patient race and physicians' performances in patient care. The sample of the study consisted of 3175 hospital episode of patients discharged from 22 short-term general hospitals in the state of Hawaii. The episodes were derived from 15 major diagnostic categories. Physicians performances were measured on the basis of the quality of medical care provided, the appropriateness of hospital admissions, and the appropriateness of hospital stays, including understays and overstays. The study has found: 1) that patient race had very limited influence on physicians' performances: the quality of medical care, the appropriateness of hospital admissions, and the appropriateness of hospital stays; 2) that Asian-Americans receive medical care equal to that of the white Americans (once they had access to the health care systems), at least in the state of Hawaii; 3) that among Asian-Americans, there was no distinct difference in medical care received by Japanese, Chinese, and Filipino; 4) that there was clear evidence of racial mutual selection between patients and physicians; and 5) that patients treated by the physicians with the same racial/ethnic backgrounds received care neither superior nor inferior to the care received by patients from the physicians with different backgrounds.

摘要

该研究试图确定患者种族与医生在患者护理方面表现之间的关联程度。该研究的样本包括夏威夷州22家短期综合医院出院患者的3175例住院病例。这些病例来自15个主要诊断类别。医生的表现是根据所提供医疗护理的质量、医院入院的适宜性以及住院时间的适宜性(包括住院时间过短和过长)来衡量的。该研究发现:1)患者种族对医生的表现影响非常有限,包括医疗护理质量、医院入院的适宜性以及住院时间的适宜性;2)至少在夏威夷州,亚裔美国人接受的医疗护理与美国白人相当(一旦他们能够使用医疗保健系统);3)在亚裔美国人中,日本裔、华裔和菲律宾裔接受的医疗护理没有明显差异;4)有明确证据表明患者与医生之间存在种族相互选择;5)由具有相同种族/族裔背景的医生治疗的患者所接受的护理既不优于也不劣于由具有不同背景的医生治疗的患者所接受的护理。

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