未满足初级保健需求的社会决定因素:系统性审查
Feben W Alemu1, Jane Yuan1, Seth Kadish1
1Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada.
许多加拿大人面临着未得到满足的初级保健需求,受收入和健康状况等社会决定因素的影响. 了解这些因素对于改善加拿大各地的医疗保健准入至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 健康的社会决定因素
背景情况:
- 初级保健是加拿大医疗保健系统的基石,旨在普及.
- 尽管有这一原则,但许多加拿大人在获得必要的初级保健服务方面遇到了障碍.
- 进行了一项系统性审查,以调查加拿大未满足的初级保健需求及其相关的社会决定因素的程度.
研究的目的:
- 系统地审查和总结有关加拿大未满足初级保健需求的现有证据.
- 确定和分析与加拿大人口中未满足的初级保健需求相关的社会决定因素.
主要方法:
- 在MEDLINE,Embase,Cochrane和Web of Science数据库中进行了全面的文献搜索,截至2023年12月.
- 包括涉及加拿大成年人 (18+) 的定量观察性研究,重点关注未满足的初级保健需求.
- 用Joanna Briggs Institute (JBI) 或纽卡斯尔-太华尺度评估偏见风险,并以叙事方式综合发现.
主要成果:
- 46项研究符合纳入标准,主要是横截面 (96%),偏差风险低 (91%).
- 在国家研究中,自我报告的未满足初级保健需求的流行率从6.6%到25.2%不等.
- 与未满足需求相关的关键社会决定因素包括低收入,心理健康诊断和慢性疾病;相反,年龄较大,健康感较好和家庭医生有负面关联.
结论:
- 虽然普及是基本原则,但社会决定因素对加拿大初级保健需求的满足状况有很大影响.
- 有证据表明,收入,心理健康和慢性疾病等因素会影响获得初级保健的机会.
- 进一步的研究对于阐明未得到满足的初级保健需求背后的机制和为干预提供信息至关重要.
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