Assessing experiences of racism among Black and White patients in the emergency department.
Assessing experiences of racism among Black and White patients in the emergency department.
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DOI：
10.1002/emp2.12870
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发表时间：
2022-12
影响因子：
2.3
通讯作者：
South, Eugenia C. C.
中科院分区：
文献类型：
--
作者：
Agarwal, Anish K. K.;Sagan, Charlotte;Gonzales, Rachel;Nijim, Sally;Merchant, Raina M. M.;Asch, David A. A.;South, Eugenia C. C.
本研究的目的是通过出院后短信调查来调查患者报告的与急诊科 (ED) 护理相关的经历的差异。这是一项针对急诊室出院患者的前瞻性队列研究，使用自动短信平台评估患者体验以及种族对急诊室护理的影响。该研究于2021年8月6日至9月24日期间进行，为期7周。参与者包括从2个城市学术急诊室出院且电子健康记录中有有效手机号码的成年人（年龄≥18岁）。我们感兴趣的主要结果是患者报告的种族对急诊科整体评分的影响。次要结果包括对护理的总体满意度以及种族对护理组成部分的影响，包括尊重、沟通和护理质量。使用 6 点李克特量表，并使用卡方和 Wilcoxon 秩和检验来分析响应。共有 590 名（14%）出院患者同意，462 名患者完成了整个调查；平均年龄为 43 岁（SD 17.3）； 67% 是女性，60.0% 是黑人。黑人患者对 ED 护理的总体评分较高（中位数 5 [3, 5]；P = 0.013）。与白人患者相比，更多的黑人患者报告种族对护理评级产生负面影响（10.8% vs 1.4%；P = 0.002）。超过四分之一的黑人患者 (27.4%) 报告说，与白人患者相比，种族对受到尊重的对待有很大影响 (P = 0.024)，22.4% 的人报告说种族对服务质量有很大影响 (P = 0.003)。卫生系统缺乏专门识别患者遭受种族主义经历的方法。我们证明了使用短信收集患者报告的种族主义经历的可行性。对于大量黑人患者来说，种族对他们的护理产生了负面影响，包括沟通、质量和尊重。
The objective of this study was to investigate the differences in patient‐reported experiences related to emergency department (ED) care using a post‐discharge text messaging survey. This was a prospective cohort study of patients discharged from the ED using an automated text messaging platform to assess patient experience and impact of race on ED care. The study was conducted for 7 weeks between August 6 and September 24, 2021. Participants included adults (aged ≥18 years) discharged from 2 urban, academic EDs with an active mobile phone number in the electronic health record. The primary outcome of interest was patient‐reported impact of race on overall rating of ED care. Secondary outcomes included overall satisfaction with care and perceived impact of race on components of care, including respect, communication, and quality of care. A 6‐point Likert scale was used, and chi‐square and Wilcoxon rank sum tests were used to analyze responses. A total of 590 (14%) discharged patients consented, and 462 patients completed the entire survey; the mean age was 43 years (SD 17.3); 67% were women, and 60.0% were Black. Black patients reported a higher overall rating of ED care (median 5 [3, 5]; P = 0.013). Proportionately, when compared with White patients, more Black patients reported that race negatively impacted the rating of care (10.8% vs 1.4%; P = 0.002). More than a quarter of Black patients (27.4%) reported race highly impacting being treated with respect (P = 0.024), and 22.4% reported a high impact on quality of service (P = 0.003) when compared with White patients. Health systems lack methods that specifically identify patient experiences of racism. We demonstrate the feasibility of using text messaging to collect patient‐reported experiences of racism. For a significant number of Black patients, race negatively impacted their care, including communication, quality, and respect.
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