Good intentions are not enough: how informatics interventions can worsen inequality
Good intentions are not enough: how informatics interventions can worsen inequality
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DOI：
10.1093/jamia/ocy052
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发表时间：
2018-08-01
影响因子：
6.4
通讯作者：
Ancker, Jessica S.
中科院分区：
文献类型：
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作者：
Veinot, Tiffany C.;Mitchell, Hannah;Ancker, Jessica S.
健康信息学干预旨在帮助人们避免、恢复或应对疾病和残疾，或改善医疗保健的质量和安全。不幸的是，它们带来了产生干预产生的不平等(IGI)的风险，因为它们不成比例地惠及更多处于有利地位的人。在这篇观点文章中，我们讨论了已知的产生免疫球蛋白I的卫生相关干预措施的特点，解释了为什么卫生信息学干预措施特别容易受到这一现象的影响，并描述了可以实施的保障措施，以改善卫生公平。我们提供了卫生信息学干预产生不平等的例子，因为它们更容易为那些来自社会经济优势群体的人获得、大量使用、遵守或有效。我们简要概述了干预开发人员和实施者可以采取的预防措施，以防止通过卫生信息学创造或恶化不平等。最后，我们讨论了确保国际地理信息系统得到承认和研究的评价方法。
Health informatics interventions are designed to help people avoid, recover from, or cope with disease and disability, or to improve the quality and safety of healthcare. Unfortunately, they pose a risk of producing intervention-generated inequalities (IGI) by disproportionately benefiting more advantaged people. In this perspective paper, we discuss characteristics of health-related interventions known to produce IGI, explain why health informatics interventions are particularly vulnerable to this phenomenon, and describe safeguards that can be implemented to improve health equity. We provide examples in which health informatics interventions produced inequality because they were more accessible to, heavily used by, adhered to, or effective for those from socioeconomically advantaged groups. We provide a brief outline of precautions that intervention developers and implementers can take to guard against creating or worsening inequality through health informatics. We conclude by discussing evaluation approaches that will ensure that IGIs are recognized and studied.