Race and Ethnicity and the Utilization of Security Responses in a Hospital Setting.

Autor: Valtis YK; Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. yvaltis@bwh.harvard.edu., Stevenson KE; Department of Data Sciences, Dana Farber Cancer Institute, Boston, MA, USA., Murphy EM; Division of Hospital Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Hong JY; Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Ali M; Division of Infectious Diseases, Department of Paediatrics, Hospital for Sick Children, Toronto, Canada., Shah S; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA., Taylor A; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA., Sivashanker K; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.; American Medical Association, Chicago, IL, USA., Shannon EM; Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2023 Jan; Vol. 38 (1), pp. 30-35. Date of Electronic Publication: 2022 May 13.
DOI: 10.1007/s11606-022-07525-1
Abstrakt: Background: Security emergency responses (SERs) are utilized by hospitals to ensure the safety of patients and staff but can cause unintended morbidity. The presence of racial and ethnic inequities in SER utilization has not been clearly elucidated.
Objective: To determine whether Black and Hispanic patients experience higher rates of SER and physical restraints in a non-psychiatric inpatient setting.
Design: Retrospective cohort study.
Participants: All patients discharged from September 2018 through December 2019.
Exposure: Race and ethnicity, as reported by patients at time of registration.
Main Outcomes: The primary outcome was whether a SER was called on a patient. The secondary outcome was the incidence of physical restraints among patients who experienced a SER.
Key Results: Among 24,212 patients, 18,755 (77.5%) patients identified as white, 2,346 (9.7%) as Black, and 2,425 (10.0%) identified with another race. Among all patients, 1,827 (7.6%) identified as Hispanic and 21,554 (89.0%) as non-Hispanic. Sixty-six (2.8%) Black patients had a SER activated during their first admission, compared to 295 (1.6%) white patients. In a Firth logit multivariable model, Black patients had higher adjusted odds of a SER than white patients (adjusted odds ratio (aOR) 1.37 [95% confidence interval: 1.02, 1.81], p = 0.037). Hispanic patients did not have higher odds of having a SER called than non-Hispanic patients. In a Poisson multivariable model among patients who had a SER called, race and ethnicity were not found to be significant predictors of restraint.
Conclusion: Black patients had higher odds of a SER compared to white patients. No significant differences were found between Hispanic and non-Hispanic patients. Future efforts should focus on assessing the generalizability of these findings, the underlying mechanisms driving these inequities, and effective interventions to address them.
(© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.)
Databáze: MEDLINE
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