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

描述(由申请人提供)：即使在控制保险地位、教育程度和其他社会经济因素的情况下，美国的少数族裔和女性患者的医疗保健结果往往比白人和男性患者更差。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的影响。然而，由于缺乏捕捉这一现象的标准化方法，进一步描述和减少患者的医疗歧视经历的努力受到限制。现在，我们在以前工作的基础上，寻求最终确定和测试一个题库，即患者报告的医疗歧视体验工具(FOREST)，该工具可用于评估以患者为中心的医疗体验，比较和报告医院级别的绩效，并最终提高医疗保健组织内的医疗服务质量。在当前的应用中，我们特别建议：)通过对康涅狄格州、弗吉尼亚州和科罗拉多州20家医院最近出院的患者的样本(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，以确定最终的题库；2)开发预测作为医院级别的评估措施，并应用作为质量改进工具；以及3)描述医院级别在预测项目上的表现与其他医院质量衡量标准之间的关系。拟议的工作是朝着标准化方法迈出的合乎逻辑的下一步，以收集有关患者医疗歧视经历的数据。为了扩大这一领域的证据基础，并为有效的干预措施提供信息，仍有必要制定一项系统的战略，研究保健组织中的歧视患者报告。

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.