改善英格兰包容性卫生群体获得初级保健的干预措施:范围审查
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
概括
在英格兰,弱势群体仍然难以获得初级保健服务. 这项审查强调了员工培训和患者倡导等干预措施的有效性,强调需要更多的评估.
科学领域:
- 公共卫生
- 医疗服务研究
- 医疗公平
背景情况:
- 尽管英格兰有普遍的接入权,但移民,无家可归者,吉普赛人,罗姆人和旅行者 (GRT) 等弱势群体面临着初级保健的障碍.
- 对于改善这些包容性健康群体的初级保健服务的有效干预措施的证据有限.
研究的目的:
- 进行旨在提高英格兰包容性卫生群体获得主流初级保健的干预措施的范围审查.
- 确定常见的干预类型,目标人群,地理重点,并评估实施的战略的有效性.
主要方法:
- 对2010年至2020年间发表的研究进行了多个数据库和灰色文献来源的全面搜索.
- 数据提取集中在英格兰针对不安全的移民身份,性交易,无家可归和GRT社区的干预.
- 通过叙事方法合成了结果.
主要成果:
- 39项研究详细介绍了38项干预措施,主要针对不安全移民身份的个人,集中在伦敦.
- 常见的干预措施包括员工/患者培训和资源,通常侧重于全科医生注册流程和社区组织的参与.
- 大多数干预措施缺乏评估 (61%),但确定的有效因素包括员工培训,患者倡导和有实践经验的人员参与.
结论:
- 包容性健康群体的干预措施是多样化的,以社区为基础的,通常是根据当地需求量身定制的.
- 政策制定者和实践者应考虑代表性不足的群体和地理区域,有效的实践要素,并优先考虑对未来干预措施的强有力的评估.
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