英国のインクルーション・ヘルス・グループに対するプライマリケアへのアクセスを改善するための介入: スコーピング・レビュー
Elspeth Carruthers1, Joanna Dobbin2, Lucy Fagan3
1Whittington Health NHS Trust, Whittington Hospital, London, UK; Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK.
Lancet (London, England)
|November 24, 2023
まとめ
英国の初等保健医療へのアクセスは 脆弱な集団にとって 課題であり続けています このレビューでは スタッフの訓練や 患者支援などの介入が 効果的であると強調し より多くの評価の必要性を強調しています
科学分野:
- 公衆衛生
- 医療サービス研究
- 健康に関する公平性
背景:
- 移民,ホームレス,ジプシー,ロマ,トラベラー (GRT) コミュニティなどの脆弱なグループは,英国における普遍的なアクセス権にもかかわらず,初等医療への障壁に直面しています.
- これらのインクルーシブな健康集団のプライマリケアへのアクセスを改善するための効果的な介入に関する証拠は限られている.
研究 の 目的:
- 英国のインクルーション・ヘルス・グループにおける主流のプライマリケアへのアクセスを改善することを目的とした介入のスコーピング・レビューを実施する.
- 共通の介入タイプ,ターゲット集団,地理的焦点を特定し,実施された戦略の有効性を評価する.
主な方法:
- 2010年から2020年の間に発表された研究について,複数のデータベースと灰色の文献のソースを徹底的に検索した.
- データの抽出は,不確実な移民状況,セックス販売,ホームレス,GRTコミュニティーを対象としたイングランドでの介入に焦点を当てました.
- 結果は物語的アプローチを用いて合成された.
主要な成果:
- 39件の調査で,38件の介入が詳細に示され,主に不確実な移民の地位を持つ人々を対象にされ,ロンドンに集中しました.
- 一般的な介入には,スタッフ/患者の訓練とリソースが含まれ,しばしばGPの登録プロセスとコミュニティ組織の関与に焦点を当てました.
- 大多数の介入は評価が欠けていた (61%),しかし,効果的な要素は,スタッフの訓練,患者の擁護,そして実体験を持つ人々の関与を含んでいた.
結論:
- 地域社会のニーズに合わせた 医療グループへの介入は多様で 地域社会に根ざしています
- 政策立案者や実務者は,不足しているグループや地域,効果的な実践の要素を考慮し,将来の介入の堅実な評価を優先すべきである.
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