健康信息和决策辅助工具能减少医疗保健中的不平等吗? 一个系统的审查
Christin Ellermann1, Jana Sophie Hinneburg1,2, Christoph Wilhelm1
1Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
基于证据的健康信息 (EBHI) 和患者决策辅助工具 (PtDA) 可以改善医疗保健决策. 然而,很少有研究检查不同的社会人口统计学群体是否同样受益,可能掩盖健康不平等.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 患者的决策制定 患者的决策
背景情况:
- 基于证据的健康信息 (EBHI) 和患者决策辅助工具 (PtDA) 对于明智的医疗保健选择至关重要.
- 社会人口统计学因素可以影响获得和从健康信息中获益,可能造成不平等.
- 之前的评估并没有一致评估这些不平等现象.
研究的目的:
- 系统地审查评估EBHI和PtDAs的研究.
- 为了确定在这些研究中考虑的不平等生产因素的程度.
- 评估不同社会人口群体在知情决策方面是否同样受益于EBHI和PtDA.
主要方法:
- 随机对照试验 (RCT) 的系统审查.
- 在多个数据库 (科克兰图书馆,MEDLINE,EMBASE等) 进行的搜索. 从开始到2023年5月.
- 包括EBHI和PtDA的RCT,这些RCT考虑了与机会不平等相关的因素 (PROGRESS-Plus标准).
主要成果:
- 只有少数研究研究了EBHI/PtDAs对与关于不平等产生因素的知情决策相关的结果的影响.
- 在12项纳入的研究中,有2项显示出干预有效性与不利地位之间的积极关联,3项显示出负面关联.
- 大多数研究都没有发现跨社会人口群体的知识获取,决策冲突或共享决策的显著差异,这可能是由于不足的子组分析.
结论:
- 在促进医疗保健决策方面,EBHI和PtDA是有效的.
- 需要更多地关注评估中的方法要求,以捕捉获得健康信息的潜在差异.
- 确保公平的医疗保健改进需要充分了解不同人群如何从EBHI和PtDAs中受益.
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