在苏格兰的一般实践中解决反向护理法:系统的范围审查
James Bogie1, Meike van Dijk2, Cara Bezzina1
1University of Glasgow, Glasgow, United Kingdom.
概括
在苏格兰的一般实践中,解决反向护理法的干预措施是不够的. 尽管有政策努力,但可持续性交付存在重大差距,需要增加投资和为贫困地区提供有针对性的资源.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 一般实践管理的管理.
背景情况:
- 反向护理法 (ICL),即医疗保健的获取与需要成反比例,在英国的一般实践中仍然存在.
- 虽然20年前在苏格兰记录了ICL,但随后的干预措施的有效性仍然不清楚.
研究的目的:
- 系统地审查自2000年以来在苏格兰一般实践中实施的旨在解决反向护理法的国家和地方干预措施.
- 确定在苏格兰初级保健机构中解决健康不平等问题的进展和挑战.
主要方法:
- 从2000年到2024年2月,对多个数据库 (EMBASE,科学网络,MEDLINE,CINAHL,Cochrane,BASE) 和灰色文献进行系统的范围审查.
- 包括定量和定性研究,使用乔安娜·布里格斯研究所工具进行质量评估.
- 对 13,089 个确定的结果进行了双重选,以选择报告 20 个不同的干预措施的 67 篇论文.
主要成果:
- 确定了20项干预措施,分为加强患者支持,针对特定疾病或群体,以及改善全方位医疗保健.
- 只有两个干预措施,社区链接工作者和福利咨询和健康伙伴关系,在全国范围内实施,面临不确定的未来资金.
- 六项干预主导着文献,占纳入论文的49%,表明专注于特定方法.
结论:
- 苏格兰政府的卫生公平政策目标与一般实践中的实际,可持续的交付之间存在很大的实施差距.
- 解决反向护理法需要在一般实践中增加整体投资.
- 建议采用"相称的普遍主义"方法,根据当地需求为更贫困地区提供额外的资源,以实现可持续的交付.
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