重新审视医院护理中的种族隔离：医疗保险出院模式及其影响。
The racial segregation of hospital care revisited: Medicare discharge patterns and their implications.
作者信息
Smith D B
机构信息
Department of Health Administration, School of Business and Management, Temple University, Philadelphia, Pa. 19122, USA.
出版信息
Am J Public Health. 1998 Mar;88(3):461-3. doi: 10.2105/ajph.88.3.461.
Abstract
OBJECTIVES
This paper measures current patterns of hospital segregation among Medicare beneficiaries.
METHODS
Data from the fiscal year 1993 Medicare Provider Analysis and Review (MEDPAR) file, the index of dissimilarity, and a linear regression model are used to test the effects of standard metropolitan area characteristics on hospital segregation.
RESULTS
The overall hospital segregation index was 0.529, ranging by state from 0.154 to 0.746. Hospital segregation in 126 standard metropolitan areas was positively related to population size, hospital density, and residential segregation and negatively related to income inequities and location in the South.
CONCLUSIONS
Racial segregation remains high and may produce both reporting biases and unequal effects of public policy.
摘要
目标
本文衡量了医疗保险受益人中目前的医院隔离模式。
方法
使用1993财年医疗保险提供者分析与审查（MEDPAR）文件的数据、差异指数和线性回归模型来检验标准大都市地区特征对医院隔离的影响。
结果
整体医院隔离指数为0.529，各州范围从0.154至0.746。126个标准大都市地区的医院隔离与人口规模、医院密度和居住隔离呈正相关，与收入不平等和位于南部呈负相关。
结论
种族隔离仍然很高，可能会产生报告偏差和公共政策的不平等影响。
相似文献
1
The racial segregation of hospital care revisited: Medicare discharge patterns and their implications.重新审视医院护理中的种族隔离：医疗保险出院模式及其影响。
Am J Public Health. 1998 Mar;88(3):461-3. doi: 10.2105/ajph.88.3.461.
2
Segregated Patterns of Hospital Care Delivery and Health Outcomes.医院医疗服务提供模式与健康结果的隔离现象。
JAMA Health Forum. 2023 Nov 3;4(11):e234172. doi: 10.1001/jamahealthforum.2023.4172.
3
Provider care segregation and hospital-region racial disparities for carotid interventions in the USA.美国颈动脉介入治疗中提供者照护隔离与医院-地区种族差异。
J Neurointerv Surg. 2024 Aug 14;16(9):864-869. doi: 10.1136/jnis-2023-020656.
4
The Role of Racial Residential Segregation in Black-White Disparities in Firearm Homicide at the State Level in the United States, 1991-2015.美国种族聚居隔离在 1991-2015 年州层面的黑-白种族间枪支凶杀差异中的作用。
J Natl Med Assoc. 2019 Feb;111(1):62-75. doi: 10.1016/j.jnma.2018.06.002. Epub 2018 Jul 11.
5
Does Hypersegregation Matter for Black-White Socioeconomic Disparities?是否存在过度隔离会影响黑-白社会经济差距？
Demography. 2019 Dec;56(6):2169-2191. doi: 10.1007/s13524-019-00825-y.
6
Geographic context of black-white disparities in Medicare CAHPS patient experience measures.医疗保险 CAHPS 患者体验测量中黑-白差异的地理背景。
Health Serv Res. 2019 Feb;54 Suppl 1(Suppl 1):275-286. doi: 10.1111/1475-6773.13091. Epub 2018 Nov 23.
7
Association of Racial Residential Segregation With Long-Term Outcomes and Readmissions After Out-of-Hospital Cardiac Arrest Among Medicare Beneficiaries.种族居住隔离与医疗保险受益人院外心脏骤停后长期结局和再入院的关系。
J Am Heart Assoc. 2023 Oct 3;12(19):e030138. doi: 10.1161/JAHA.123.030138. Epub 2023 Sep 26.
8
Racial segregation and disparities in health care delivery: conceptual model and empirical assessment.医疗服务中的种族隔离与差异：概念模型与实证评估
Health Serv Res. 2009 Aug;44(4):1424-44. doi: 10.1111/j.1475-6773.2009.00977.x. Epub 2009 May 7.
9
The Relationship between Racial Residential Segregation and Black-White Disparities in Fatal Police Shootings at the City Level, 2013-2017.2013-2017 年市级层面种族居住隔离与警察枪杀黑-白人群差异的关系
J Natl Med Assoc. 2019 Dec;111(6):580-587. doi: 10.1016/j.jnma.2019.06.003. Epub 2019 Jun 27.
10
Separate and Sick: Residential Segregation and the Health of Children and Youth in Metropolitan Statistical Areas.分离与患病：大都市区的居住隔离与儿童和青少年健康
J Urban Health. 2019 Apr;96(2):149-158. doi: 10.1007/s11524-018-00330-4.
引用本文的文献
1
Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.2013年至2021年医疗保险受益人的医院护理按种族、族裔和双重资格状态的隔离情况。
Health Serv Res. 2025 Apr;60 Suppl 2(Suppl 2):e14434. doi: 10.1111/1475-6773.14434. Epub 2025 Jan 11.
2
Transporting difference-in-differences estimates to assess health equity impacts of payment and delivery models.运用双重差分估计法来评估支付与服务提供模式对健康公平性的影响。
Health Serv Res. 2025 Apr;60 Suppl 2(Suppl 2):e14419. doi: 10.1111/1475-6773.14419. Epub 2024 Dec 19.
3
Disparities in end-of-life care for minoritized racial and ethnic patients during terminal hospitalizations in New York State.纽约州终末期住院治疗中少数民族患者在临终关怀方面的差异。
J Am Geriatr Soc. 2024 Sep;72(9):2690-2699. doi: 10.1111/jgs.19046. Epub 2024 Jul 10.
4
Measuring Local-Area Racial Segregation for Medicare Hospital Admissions.测量 Medicare 住院患者的局部区域种族隔离程度。
JAMA Netw Open. 2024 Apr 1;7(4):e247473. doi: 10.1001/jamanetworkopen.2024.7473.
5
Structural Racism and Use of Labor Neuraxial Analgesia Among Non-Hispanic Black Birthing People.结构性种族主义与非西班牙裔黑人产妇使用分娩镇痛。
Obstet Gynecol. 2024 Apr 1;143(4):571-581. doi: 10.1097/AOG.0000000000005519. Epub 2024 Feb 1.
6
Segregated Patterns of Hospital Care Delivery and Health Outcomes.医院医疗服务提供模式与健康结果的隔离现象。
JAMA Health Forum. 2023 Nov 3;4(11):e234172. doi: 10.1001/jamahealthforum.2023.4172.
7
Relationship between Racial Diversity in Medical Staff and Hospital Operational Efficiency: An Empirical Study of 3870 U.S. Hospitals.医务人员种族多样性与医院运营效率之间的关系：对3870家美国医院的实证研究
Behav Sci (Basel). 2023 Jul 6;13(7):564. doi: 10.3390/bs13070564.
8
Implementation and outcomes of a system-wide women's health 'team goal' to reduce maternal morbidity for black women: a prospective quality improvement study.系统范围的妇女健康“团队目标”实施及成果：降低黑人女性产妇发病率的前瞻性质量改进研究。
BMJ Open Qual. 2022 Nov;11(4). doi: 10.1136/bmjoq-2022-002061.
9
Vermont Oxford Network: a worldwide learning community.佛蒙特牛津网络：一个全球性的学习社区。
Transl Pediatr. 2019 Jul;8(3):182-192. doi: 10.21037/tp.2019.07.01.
10
The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families.健康的色彩：种族主义、隔离和不平等如何影响早产儿及其家庭的健康和福祉。
Pediatr Res. 2020 Jan;87(2):227-234. doi: 10.1038/s41390-019-0513-6. Epub 2019 Jul 29.
本文引用的文献
1
Segregation and discrimination in medical care in the United States.美国医疗保健中的隔离与歧视。
Am J Public Health Nations Health. 1956 Sep;46(9):1074-81. doi: 10.2105/ajph.46.9.1074.
2
Effects of race and income on mortality and use of services among Medicare beneficiaries.种族和收入对医疗保险受益人的死亡率及服务使用情况的影响。
N Engl J Med. 1996 Sep 12;335(11):791-9. doi: 10.1056/NEJM199609123351106.
3
Health care for black and poor hospitalized Medicare patients.为黑人及贫困住院医疗保险患者提供的医疗服务。
JAMA. 1994 Apr 20;271(15):1169-74.
4
Good-bye to Jim Crow: the desegregation of Southern hospitals, 1945-70.
Bull Hist Med. 1986 Fall;60(3):367-86.
5
Desegregation of hospitals and medical societies in North Carolina.北卡罗来纳州医院和医学协会的种族隔离废除。
N Engl J Med. 1988 Jan 7;318(1):58-63. doi: 10.1056/NEJM198801073180127.
6
Zotero 插件