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首页> 外文期刊>Journal of pain and symptom management. >Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity
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Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity

机译：通过种族和种族在急性护理环境中提供小学和特色姑息治疗的差距

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Abstract Context Previous research has identified a large unmet need in provision of specialist-level palliative care services in the hospital. How much of this gap is filled by primary palliative care provided by generalists or nonpalliative specialists has not been quantified. Estimates of racial and ethnic disparities have been inconsistent. Objectives The objective of this study was to 1) estimate primary and specialty palliative care delivery and to measure unmet needs in the inpatient setting and 2) explore racial and ethnic disparities in palliative care delivery. Methods This was a cross-sectional, retrospective study of 55,658 adult admissions to two acute care hospitals in the Bronx in 2013. Patients with palliative care needs were identified by criteria adapted from the literature. The primary outcomes were delivery of primary and specialist-level palliative care. Results In all, 18.5% of admissions met criteria for needing palliative care. Of those, 18% received specialist-level palliative care, an estimated 30% received primary palliative care, and 37% had no evidence of palliative care or advance care planning. Black and Hispanic patients were not less likely to receive specialist-level palliative care (adjusted odds ratio [OR] black patients?=?1.18, 95% CI 0.98, 1.42; adjusted OR Hispanic patients?=?1.24, 95% CI 1.04, 1.48), but they were less likely to receive primary palliative care (adjusted OR black patients?=?0.41, 95% CI 0.20, 0.84; adjusted OR Hispanic patients?=?0.48, 95% CI 0.25, 0.94). Conclusion Even when considering primary and specialty palliative care, hospitalized patients have a high prevalence of unmet palliative care need. Further research is needed understand racial and ethnic disparities in palliative care delivery.
机译：摘要背景以前的研究确定了在医院提供专业级姑息治疗服务的大量未满足需求。通过一般主义者或非专科专家提供的主要姑息治疗填补了多少这间差距尚未量化。对种族和民族差异的估计是不一致的。目的本研究的目的是1）估计主要和专业姑息治疗，并在住院环境中测量未满足的需求，2）探讨姑息治疗中的种族和民族差异。方法这是2013年Bronx中的两个急性护理医院55,658名成人录取的横断面程，回顾性研究。通过文献调整的标准确定了姑息治疗的患者。主要结果是发出小学和专业水平的姑息治疗。结果所有，18.5％的招生达到需要姑息治疗的标准。其中18％获得专家级别的姑息治疗，估计有30％的主要姑息治疗，37％没有姑息治疗或提前护理计划的证据。黑人和西班牙裔患者不太可能接受专业水平的姑息治疗（调整的赔率比[或]黑患者？=？1.18,95％CI 0.98,1.42;调整后或西班牙裔患者？=？1.24,95％CI 1.04， 1.48），但它们不太可能接受初级姑息治疗（调整或黑色患者？=？0.41,95％CI 0.20,0.84;调整后或西班牙裔患者？= 0.48,95％CI 0.25,0.94）。结论即使在考虑小学和专业的姑息治疗时，住院患者也有很高的未满足姑息治疗的需求。需要进一步研究，了解姑息治疗的种族和民族差异。

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