Racial Disparities in Barriers to Care for Patients With Diabetic Retinopathy in a Nationwide Cohort.
Racial Disparities in Barriers to Care for Patients With Diabetic Retinopathy in a Nationwide Cohort.
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DOI：
10.1167/tvst.12.3.14
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发表时间：
2023-03-01
影响因子：
3
通讯作者：
Baxter, Sally L.
中科院分区：
文献类型：
--
作者：
Huang, Bonnie B.;Saseendrakumar, Bharanidharan Radha;Delavar, Arash;Baxter, Sally L.
关键词：
确定不同种族/民族的糖尿病视网膜病变(DR)患者的具体护理障碍。在这项横断面研究中，我们纳入了美国国立卫生研究院所有人研究计划的成年参与者，其中DR回答了医疗保健获取与利用调查和健康的社会决定因素(SDoH)调查中的问题。采用Logistic回归方法研究护理障碍与种族/民族之间的关系。我们的队列包括885名回答医疗服务获取和利用调查的DR患者和385名回答SDoH调查的DR患者。在调整混杂因素后，西班牙裔个体比非西班牙裔白人个体更有可能报告由于无法获得儿童护理而推迟接受医疗护理(优势比[OR]=6.57[95%可信区间{CI}，1.67-27.8])。此外，与非西班牙裔白人相比，非西班牙裔黑人在去医生办公室或其他医疗保健提供者时报告受到的尊重较少(OR=2.62[95%CI，1.15-5.80])，受到的礼遇较少(OR=2.51[95%CI，1.01-5.92])，得到的服务也比其他人差(OR=2.85[95%CI，1.25-6.34])。我们发现，即使在控制了个性化的社会经济因素后，患有糖尿病视网膜病变的西班牙裔和非西班牙裔黑人个体报告的护理延迟/障碍比非西班牙裔白人个体更大。这项研究强调了采取措施促进健康公平的重要性，例如增加获得儿童护理资源的机会，减少眼科护理提供者之间的隐性偏见，以增加获得护理的机会，防止Dr。
To ascertain specific barriers of care among patients with diabetic retinopathy (DR) from different racial/ethnic groups. In this cross-sectional study, we included adult participants in the National Institutes of Health All of Us Research Program with DR who answered questions in the Healthcare Access & Utilization survey and Social Determinants of Health (SDoH) survey. Logistic regression was used to study the association between barriers to care and race/ethnicity. Our cohort included 885 DR patients who answered the Healthcare Access & Utilization survey and 385 DR patients who responded to the SDoH survey. After adjusting for confounders, Hispanic individuals were more likely than non-Hispanic White individuals to report delaying getting medical care due to not being able to get child care (odds ratio [OR] = 6.57 [95% confidence interval {CI}, 1.67–27.8]). Furthermore, compared to non-Hispanic White individuals, non-Hispanic Black individuals were significantly more likely to report being treated with less respect (OR = 2.62 [95% CI, 1.15–5.80]), treated with less courtesy (OR = 2.51 [95% CI, 1.01–5.92]), and receive poorer service than other people (OR = 2.85 [95% CI, 1.25–6.34]) when they go to a doctor's office or other healthcare provider. We found that Hispanic and non-Hispanic Black individuals with DR reported greater delays/barriers to care compared to non-Hispanic White individuals even after controlling for individualized socioeconomic factors. This study highlights the importance of taking steps to promote health equity, such as increasing access to child care resources and reducing implicit bias among eye care providers, to increase access to care and prevent vision loss from DR.
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DOI：
10.1056/nejmsr1809937
发表时间：
2019-08-15
期刊：
The New England journal of medicine
影响因子：
--
作者：
All of Us Research Program Investigators;Denny JC;Rutter JL;Goldstein DB;Philippakis A;Smoller JW;Jenkins G;Dishman E
通讯作者：
Dishman E
影响因子：
8.1
作者：
Kaakour, Abdul-Hadi;Hua, Hong-Uyen;Rachitskaya, Aleksandra
通讯作者：
Rachitskaya, Aleksandra
影响因子：
4.2
作者：
Cuevas, Adolfo G.;O'Brien, Kerth;Saha, Somnath
通讯作者：
Saha, Somnath
影响因子：
2
作者：
Marahrens L;Kern R;Ziemssen T;Fritsche A;Martus P;Ziemssen F;Roeck D
通讯作者：
Roeck D
影响因子：
1.8
作者：
Griffith, Derek M.;Allen, Julie Ober;Gunter, Katie
通讯作者：
Gunter, Katie