Measuring racial/ethnic discrimination in healthcare settings

衡量医疗保健环境中的种族/民族歧视

基本信息

批准号：
7963676
负责人：
Marcella Nunez-Smith
金额：
$ 18万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7963676
关键词：
Accounting Acute Adherence Administrator African American American Indian and Alaska Native Area Asians Caring Characteristics Cognitive Communities Comprehension Connecticut Data Data Quality Development Discrimination Educational Background Ethnic group Frequencies Future Health Health Personnel Health behavior Healthcare Hispanics Home environment Hospitals Income Individual Inpatients Institute of Medicine (U.S.)Institution Insurance Coverage Internal Medicine Interview Knowledge Libraries Literature Mails Manuscripts Measurement Measures Medicine Minority Minority Groups Modeling NIH Program Announcements Online Systems Outcome Pacific Island Americans Participant Patient Discharge Patient Self-Report Patient-Centered Care Patients Peer Review Perception Performance Persons Play Policy Research Prevalence Property Psychometrics Publishing Quality of Care Questionnaires Recommendation Recruitment Activity Reporting Research Research Personnel Respondent Review Literature Role Sampling Screening for cancer Self-Administered Series Services Social Interaction Study Section Testing United States United States Agency for Healthcare Research and Quality Variant Work base community based evaluation design effective intervention ethnic discrimination evidence base experience health care service utilization health disparity improved informant maltreatment meetings novel population based public health relevance racial and ethnic racial and ethnic disparities response satisfaction standardize measure statistics systematic review theories

项目摘要

DESCRIPTION (provided by applicant): Racial/ethnic minority patients in the United States typically have worse health outcomes when compared with their non-minority counterparts. Health and healthcare inequities across racial/ethnic groups persist despite taking into account important factors such as insurance coverage, patient health behaviors, level of education, and income or wealth. A growing body of evidence suggests that discrimination may play an important role in creating and sustaining differences in healthcare utilization and health outcomes. Several studies conclude that racial/ethnic minority patients are more likely to report discriminatory experiences when interacting within healthcare settings than non-minority patients. Although the existing research demonstrates that patient perceptions of discrimination within healthcare settings are common and relevant, the variation in measurement across studies highlights the need for a standard measurement of perceived discrimination from the patient perspective. We, therefore, conducted a series of in-person key informant interviews with a purposeful, racially/ethnically diverse sample of patients, healthcare providers, community leaders, and healthcare administrators across the state of Connecticut to characterize discrimination within healthcare settings. Our analyzed findings will ultimately inform the development of a patient questionnaire that can be used to assess patient-centered care, to compare and report on performance, and to ultimately improve the quality of care within healthcare organizations. In this application, we specifically propose to: 1) develop a comprehensive set of candidate items for the questionnaire based upon original qualitative data, expert panel evaluation, community-based panel input, extensive literature review, and cognitive interviews with community-dwelling participants across Connecticut; and 2) field test the items to assess preliminary quantitative characteristics of the items across our sample of recently-discharged patients from inpatient medicine services in Connecticut. The proposed work is the critical first step towards development of a standardized questionnaire. A systematic strategy towards the study of patient perceptions of discrimination across healthcare organizations is needed to expand the evidence base in this area and to inform effective interventions. PUBLIC HEALTH RELEVANCE: Existing research suggests that perceived racial/ethnic discrimination within healthcare settings contribute to persistent racial/ethnic disparities in health but there is wide variation in how perceived discrimination is measured. The development and testing of a comprehensive item pool is the essential groundwork towards creating a standardized measure of perceived healthcare discrimination, a critical step in reducing and eventually eliminating any contribution of healthcare discrimination to health disparities in the United States.

描述（由申请人提供）：与非少数人相比，美国的种族/少数民族患者通常的健康状况较差。尽管考虑到重要因素，例如保险范围，患者健康行为，教育水平以及收入或财富，但种族/族裔群体的健康和医疗保健不平等仍然存在。越来越多的证据表明，歧视可能在创造和维持医疗保健利用和健康结果差异方面起重要作用。几项研究得出的结论是，在医疗保健环境中互动时，种族/少数民族患者比非少数患者更有可能报告歧视性经历。尽管现有的研究表明，医疗保健环境中患者对歧视的看法是普遍且相关的，但整个研究的测量的差异突显了从患者的角度对感知歧视的标准测量的需求。因此，我们对康涅狄格州各地的患者，医疗保健提供者，社区领导者和医疗保健管理人员进行了有目的，种族/种族多样的患者样本，对医疗保健环境中的歧视表征歧视的患者，医疗保健提供者，社区领导者和医疗保健管理员进行了一系列面对面的关键知情人访谈。我们分析的发现最终将为患者问卷的开发提供信息，该问卷可用于评估以患者为中心的护理，比较和报告绩效，并最终提高医疗保健组织内的护理质量。在本应用程序中，我们特别建议：1）根据原始定性数据，专家小组评估，基于社区的小组投入，广泛的文献审查以及与康涅狄格州各地社区居住的参与者的认知访谈，为问卷开发了一组全面的候选项目； 2）现场测试项目，以评估我们在康涅狄格州住院医学服务中最近递送的患者样本中这些项目的初步定量特征。拟议的工作是迈向标准化问卷的关键第一步。需要一种系统的策略来研究患者对跨医疗组织歧视的看法，以扩大该领域的证据基础并为有效的干预提供信息。公共卫生相关性：现有的研究表明，在医疗保健环境中，感知的种族/族裔歧视有助于持续的健康差异，但如何衡量感知的歧视情况有很大差异。综合项目池的开发和测试是建立一种标准化的感知医疗保健歧视的标准化量的基本基础，这是减少医疗保健歧视对健康差异的任何贡献的关键一步。