Achieving Injury-related Health Equity in the National Trauma Healthcare System

在国家创伤医疗保健系统中实现与伤害相关的健康公平

• 批准号: 9981511
• 负责人: Megan Moore
• 金额: $ 16.9万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9981511
• 关键词: Accident and Emergency department; Accounting; Address; Adult; Affect; American College of Surgeons; Anxiety; Area; Asians; Caring; Categories; Cause of Death; Cessation of life; Characteristics; Color; Communicable Diseases; Consensus; Data; Data Collection; Data Sources; Development; Ensure; Family Sizes; Geographic Locations; Geography; Goals; Health; Health Priorities; Health Status; Healthcare; Healthcare Systems; Hospitals; Hour; Income; Individual; Infrastructure; Injury; Intervention; Interview; Language; Lead; Leadership; Limited English Proficiency; Longevity; Measures; Medical; Medical center; Mental Depression; Outcome; Patients; Pattern; Persons; Phase; Policies; Prevention; Prevention Research; Preventive Intervention; Procedures; Process; Race; Registries; Research; Research Personnel; Risk; SF-12; Sampling; Subgroup; Survival Rate; System; Testing; Time; Trauma; Trauma patient; Uninsured; Universities; Violence; Washington; Work; age group; aged; base; cohort; cost; data warehouse; disability; follow-up; health disparity; health equity; health related quality of life; improved; injured; injury prevention; instrument; phrases; programs; racial and ethnic; secondary outcome; symposium

ABSTRACT The consequences of injuries and violence disproportionately impact persons of color, uninsured individuals, those with limited English proficiency, and those who are geographically isolated. Injuries are the leading cause of death and disability for those aged 1-44 years in the US, and each year 2.5 million individuals are hospitalized and 26.9 million are treated in the Emergency Department as a result of injuries. Total lifetime medical and work loss costs associated with injuries are estimated at $671 billion/year. Existing state-level trauma registry systems currently collect data on injuries, injury care, and patient characteristics and contribute these data to the national trauma databank and the Trauma Quality Improvement Program of the American College of Surgeons. However, there are significant limitations in the current trauma registry systems. Data are not collected on equity-related factors beyond race, such as primary language spoken or income or on longer- term outcomes after hospital discharge. Our group conducted a national Delphi process with key experts to identify a national agenda in injury and health equity. Key priorities included: 1) Inclusion of health equity- related measures in trauma registries and 2) Need for longer-term follow up of patients to examine how local practices and system factors affect the health of injured patients over time and lead to outcome disparities. Systematically accounting for care factors and outcomes by health-equity measures is a critical step towards developing system-level interventions to alleviate health disparities. This study aims to address these priorities within our Trauma Registry system by developing and testing the feasibility of a culturally sensitive data collection instrument and process that can be included in the existing trauma registry systems to capture health equity measures and longer-term outcomes for diverse trauma patients. We will also examine the relationship between health equity measures and longer-term outcomes in a cohort of injury patients. The overarching goal of this proposal is to reduce injury disparities, improve the survival rates and health of trauma patients, and advance equitable injury care. Results of this study will demonstrate that inclusion of health equity measures and longer-term tracking of outcomes allows for identification of important outcomes associated with health equity measures. This will inform creation of prevention and post-injury intervention efforts that will have sustained impact on the lives of vulnerable persons most at risk for injury and violence.

摘要 伤害和暴力的后果不成比例地影响到有色人种，没有保险的个人， 英语水平有限的人，以及地理位置偏远的人。受伤是主要原因 在美国，1-44岁的人死亡和残疾的原因，每年有250万人 2690万人因受伤住院，2690万人因受伤在急诊室接受治疗。总寿命 与伤害有关的医疗和工作损失费用估计为每年6710亿美元。现有州级 创伤登记系统目前收集有关损伤、损伤护理和患者特征的数据， 这些数据到国家创伤数据库和美国创伤质量改善计划， 外科医学院然而，目前的创伤登记系统存在明显的局限性。数据 不收集种族以外的公平相关因素，如主要语言或收入或更长的时间- 出院后的长期结局。我们的小组与主要专家一起进行了一次全国性的德尔菲程序， 确定伤害和健康公平的国家议程。主要优先事项包括：1）纳入卫生公平- 2）需要对患者进行长期随访，以检查当地 随着时间的推移，实践和制度因素影响受伤患者的健康，并导致结果差异。 通过健康公平措施系统地说明护理因素和结果是实现健康公平的关键一步。 制定系统一级的干预措施，以减轻健康差距。本研究旨在解决这些优先事项 通过开发和测试文化敏感数据的可行性， 收集工具和过程，可以包括在现有的创伤登记系统，以捕捉健康 公平的措施和长期的结果为不同的创伤患者。我们还将研究 在一组受伤患者中，健康公平措施和长期结果之间的关系。总体目标 该提案的目的是减少伤害差异，提高创伤患者的存活率和健康状况， 促进公平的伤害护理。这项研究的结果将表明，纳入健康公平措施， 长期跟踪结果可以识别与健康相关的重要结果 公平措施。这将为预防和受伤后干预工作的建立提供信息， 对最易遭受伤害和暴力的弱势群体的生活产生持续影响。