基于流程挖掘的健康公平监测框架。

PLOS digital health Pub Date : 2024-08-28 eCollection Date: 2024-08-01 DOI:10.1371/journal.pdig.0000575
Jan Niklas Adams, Jennifer Ziegler, Matthew McDermott, Molly J Douglas, René Eber, Judy Wawira Gichoya, Deirdre Goode, Swami Sankaranarayanan, Ziyue Chen, Wil M P van der Aalst, Leo Anthony Celi
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引用次数: 0

摘要

在美国,有人建议将医院医疗保险支付与健康公平措施挂钩,这表明有必要精确衡量医疗保健服务的公平性。尽管有大量研究表明在医疗保健结果和获取方面存在差距,但在用于评估各种健康状况和治疗的健康公平性的工具方面存在明显差距。现有的工具通常只关注病人护理的某一个方面,如药物提供,而未能对整个医疗过程进行检查。本研究的目的是提出一个流程挖掘框架,以提供一个全面的健康公平视角。这种方法使用事件日志来跟踪病人护理过程中的所有操作,使我们能够审视单个和多个治疗步骤中的差异,以及更广泛的治疗策略中的差异。我们将这一框架应用于重症监护室(ICU)脓毒症患者的管理,重点关注性别和英语水平。我们发现,对男性和女性患者的治疗没有明显差异。然而,对于不会说英语的病人,尽管他们的病情同样严重,随后的治疗也相似,但开始治疗的时间却明显延迟。这一框架涵盖了现有的衡量医疗不平等的单个方法,提供了一种精确定位和深入研究医疗不平等的综合方法,为旨在实现更公平医疗的研究和政策制定提供了宝贵的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A health equity monitoring framework based on process mining.

In the United States, there is a proposal to link hospital Medicare payments with health equity measures, signaling a need to precisely measure equity in healthcare delivery. Despite significant research demonstrating disparities in health care outcomes and access, there is a noticeable gap in tools available to assess health equity across various health conditions and treatments. The available tools often focus on a single area of patient care, such as medication delivery, but fail to examine the entire health care process. The objective of this study is to propose a process mining framework to provide a comprehensive view of health equity. Using event logs which track all actions during patient care, this method allows us to look at disparities in single and multiple treatment steps, but also in the broader strategy of treatment delivery. We have applied this framework to the management of patients with sepsis in the Intensive Care Unit (ICU), focusing on sex and English language proficiency. We found no significant differences between treatments of male and female patients. However, for patients who don't speak English, there was a notable delay in starting their treatment, even though their illness was just as severe and subsequent treatments were similar. This framework subsumes existing individual approaches to measure health inequities and offers a comprehensive approach to pinpoint and delve into healthcare disparities, providing a valuable tool for research and policy-making aiming at more equitable healthcare.

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