紧急服务的地理可访问性和婴儿死亡率之间的关系:系统性审查和元分析
Patrícia Meireles Brito1, Katia Suely Queiroz Silva Ribeiro2, Renato S Melo1,3
1Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
Journal of paediatrics and child health
|August 2, 2024
概括
紧急服务的地理可访问性显著影响婴儿死亡率. 较长的旅行距离和时间增加了婴儿死亡的风险,突出了严重的公共卫生问题.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 儿科 儿科 儿科
背景情况:
- 婴儿死亡率仍然是一个重大的全球卫生挑战.
- 获得紧急医疗服务的可用性是健康结果的关键决定因素.
- 了解到紧急护理的旅行时间/距离与婴儿死亡率之间的联系对于有针对性的干预至关重要.
研究的目的:
- 系统地审查和元分析现有关于紧急服务可访问性和婴儿死亡率之间的关系的研究.
- 评估研究中研究这种关联的方法质量和偏差风险.
主要方法:
- 进行了全面的系统审查和元分析,搜索了多个电子数据库 (Medline/PubMed,Embase,SciElo,Lilacs,Scopus,Web of Science).
- 纳入标准侧重于观察性研究,将婴儿死亡率与儿科紧急情况的旅行距离或时间联系起来.
- 方法质量使用GRADE进行评估,偏差风险使用纽卡斯尔-太华尺度进行评估.
主要成果:
- 分析显示,旅行距离/时间增加和婴儿死亡率之间存在统计学意义上的关联.
- 超过5公里到达急救服务的儿童死亡风险增加了28% (P=0.002).
- 超过40分钟的旅行时间与45%的婴儿死亡风险增加有关 (P<0.001).
结论:
- 紧急服务的地理可访问性 (距离和时间) 减少与婴儿死亡率增加之间存在明显的关系.
- 包含的研究的整体方法质量主要为中度至低,表明需要更高质量的研究.
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