Validating the Patient-reported Experiences of Discrimination in Care Tool (PreDi

验证患者报告的护理工具歧视经历 (PreDi

• 批准号: 8345240
• 负责人: Marcella Nunez-Smith
• 金额: $ 70.23万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8345240
• 关键词: Address; Adherence; Applications Grants; Area; Caring; Case-Mix Adjustments; Cognitive; Colorado; Communication; Communities; Companions; Complement; Connecticut; Data; Data Collection; Discrimination; Education; Ethnic Origin; Exploratory/Developmental Grant; Female; Focus Groups; Frequencies; Health; Health Personnel; Health Status; Healthcare; Healthcare Systems; Home environment; Hospitals; Individual; Information Systems; Inpatients; Insurance Coverage; Internal Medicine; Intervention; Intervention Studies; Interview; Knowledge; Language; Literature; Measurement; Measures; Medical Research; Minority Groups; Modeling; Outcome; Patient Discharge; Patient Outcomes Assessments; Patient Self-Report; Patients; Performance; Policies; Policy Research; Population; Process; Psychometrics; Quality Indicator; Quality of Care; Questionnaires; Race; Recruitment Activity; Reporting; Research; Sampling; Schedule; Screening for cancer; Self-Administered; Services; Socioeconomic Factors; Solutions; Staging; System; Techniques; Testing; Translating; United States; United States National Institutes of Health; Virginia; Work; base; care delivery; effective intervention; ethnic discrimination; evidence base; experience; health disparity; improved; male; member; novel; patient oriented; racial and ethnic; racial and ethnic disparities; response; satisfaction; statistics; tool

DESCRIPTION (provided by applicant): Racial/ethnic minority and female patients in the United States often have worse healthcare outcomes when compared with white and male patients even when controlling for insurance status, education, and other socioeconomic factors. A growing body of research seeks to understand the contribution interpersonal and institutional bias to these observed inequities. However, efforts to further describe and reduce patient experiences of healthcare discrimination are limited by the lack of a standardized approach to capture this phenomenon. We now build upon our earlier work and seek to finalize and test an item bank, the Patient-Reported Experiences of Discrimination in Care Tool (PreDict), that can be used to assess the patient-centeredness of the care experience, to compare and report on hospital-level performance, and to ultimately improve the quality of care delivery within healthcare organizations. In this current application, we specifically propose to: ) apply advanced statistical techniques to a set of candidate items after field testing them with a sample (n=6000) of patients recently discharged from twenty hospitals across the states of Connecticut, Virginia, and Colorado in order to determine the finalized item bank; 2) develop PreDict as a hospital-level assessment measure with application as a quality improvement tool; and 3) describe the relationship between hospital-level performance on PreDict items and other measures of hospital quality. The proposed work is the logical next step towards a standardized approach to data collection on patient experiences of healthcare discrimination. A systematic strategy towards the study of patient reports of discrimination across healthcare organizations remains necessary to expand the evidence base in this area and to inform effective interventions. PUBLIC HEALTH RELEVANCE: Existing research suggests that patient-reported racial/ethnic discrimination within healthcare settings contributes to persistent racial/ethnic disparities in health but a standard measurement approach to capture these experiences is lacking. Refining and calibrating the Patient-reported experiences of discrimination in care tool (PreDict) as a hospital-level performance measure is 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）：即使在控制保险状况、教育程度和其他社会经济因素的情况下，与白人和男性患者相比，美国的少数族裔/族裔和女性患者的医疗结果往往更差。越来越多的研究试图了解人际和制度偏见对这些观察到的不平等现象的影响。然而，由于缺乏捕捉这种现象的标准化方法，进一步描述和减少患者遭受医疗保健歧视的经历的努力受到限制。现在，我们在早期工作的基础上，寻求最终确定和测试一个项目库，即患者报告的护理歧视经历工具 (PreDict)，该项目可用于评估护理体验以患者为中心的程度，比较和报告医院层面的绩效，并最终提高医疗机构内的护理服务质量。在当前的应用程序中，我们特别建议：) 在使用康涅狄格州、弗吉尼亚州和科罗拉多州 20 家医院最近出院的患者样本 (n=6000) 进行现场测试后，将先进的统计技术应用于一组候选项目，以确定最终的项目库； 2）将PreDict开发为医院级评估措施，并作为质量改进工具应用； 3) 描述医院层面在 PreDict 项目上的表现与医院质量的其他衡量标准之间的关系。拟议的工作是朝着标准化方法收集有关医疗保健歧视患者经历的数据的合理下一步。仍然有必要对医疗保健组织中的患者报告歧视问题进行系统性研究，以扩大该领域的证据基础并为有效的干预措施提供信息。 公共卫生相关性：现有研究表明，患者报告的医疗保健环境中的种族/民族歧视会导致健康方面持续存在的种族/民族差异，但缺乏捕捉这些经历的标准测量方法。完善和校准患者报告的护理歧视经历工具 (PreDict) 作为医院层面的绩效衡量标准，是减少并最终消除医疗保健歧视对美国健康差异的任何影响的关键一步。