Equal rights, equal respect: an examination of differential inpatient experience in the NHS
Equal rights, equal respect: an examination of differential inpatient experience in the NHS
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平等权利，平等尊重：NHS 住院患者体验差异的考察
DOI：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
S. Sizmur
中科院分区：
文献类型：
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作者：
Katherine Korner;S. Sizmur
在国家医疗服务体系 (NHS) 中，患者在急症医院信托机构中的护理经历是通过 NHS 患者调查计划来衡量的。 这些调查使用大量患者样本，并包括有关《2010 年平等法案》中规定的“受保护特征”的问题。对 2011 年住院患者调查中衡量尊严和尊重治疗的一项数据进行了检查。使用多级回归模型对它们进行分析，并将“医院信任”作为随机效应。患者特征作为固定主效应输入，然后作为双向交互作用输入。 研究了允许斜率系数随这些特性变化的影响。 受到尊重和尊严对待的负面经历与多个人口类别有关，包括年轻人、女性、无宗教或“其他”宗教的人、男同性恋/女同性恋或双性恋者、不透露其宗教或性取向的人、特定种族和某些慢性病。 性别和其他背景变量之间存在显着的相互作用，包括年龄、性取向、种族、宗教信仰和某些慢性病。随机斜率模型表明，某些群体的经历对医院的信任水平存在很大差异。 结果与之前的发现一致，但与宗教和性行为有关，迄今为止尚未获得这方面的数据。 然而，这些报告的差异在多大程度上可能是由于不同的期望、报告行为或歧视造成的，目前尚不清楚。 研究结果提供了一个起点，提供者可以分析这些做法，以确定它们在哪些方面可能会导致尊严和尊重待遇方面的差异。
In the National Health Service (NHS), patients’ experiences of care episodes in acute hospital trusts are measured through the NHS patient survey programme. These surveys use large samples of patients and include questions about ‘protected characteristics’ as set out in the Equalities Act 2010. Data were examined for one item in the 2011 Inpatient Survey measuring treatment with dignity and respect. They were analysed using multilevel regression models, incorporating ‘hospital trust’ as a random effect. Patient characteristics were entered as fixed main effects, and then as two-way interactions. The effect of allowing slope coefficients to vary for these characteristics was investigated. More negative reported experience of being treated with respect and dignity was associated with several demographic categories, including younger people, women, those affiliated with no or ‘another’ religion, gay/lesbian or bisexual individuals, those who did not disclose their religion or sexual orientation, specific ethnicities and certain chronic conditions. There were significant interactions between gender and other background variables, including age, sexual orientation, ethnicity, religious affiliation and certain chronic conditions. Random slope models suggested large hospital-trust-level variation in theexperience of certain groups. The results align with previous findings but are of particular interest in relation to religion and sexuality, for which data have hitherto been unavailable. However, the extent to which these reported differences might be due to differential expectations, reporting behaviours or discrimination is not clear. The results provide a starting point from which providers can analyse practices to identify where they might give rise to differences in treatment with dignity and respect.