通过复杂的健康干预来准健康公平:使用哪些评估方法和设计? 一个范围审查审查
Iñaki Blanco-Cazeaux1, Thomas Ferté2, Coline Bruzek3
1University of Bordeaux, 351 cours de la Libération, Talence, Cedex, 33405, France; Bordeaux Population Health research center (Inserm U1219) - PHARes team, 146 rue Léo Saignat, Cedex, 33076, Bordeaux, France; Université Bourgogne Europe, Laboratoire d'Économie de Dijon (UMR CNRS 6307), 2 boulevard Gabriel, Cedex, 21066, Dijon, France.
旨在减少健康不平等 (HI) 的公共卫生干预措施通常不会使用经济指标进行评估. 这项研究强调了明确测量HI减少的必要性,以避免意外的差异.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 健康 公平 卫生 公平
背景情况:
- 健康不平等 (HI) 代表了系统的,可以避免的健康结果差异.
- 许多公共卫生倡议旨在减少HI,但它们的评估不一致.
- 评估干预措施对HI的影响对于有效的公共卫生政策至关重要.
研究的目的:
- 评估经济指标和方法在评估复杂卫生干预措施中的HI减少时被使用的程度.
- 确定针对HI的公共卫生干预措施的评估中当前的做法和差距.
- 为衡量卫生干预措施对差异影响的方法改进提供信息.
主要方法:
- 在Arksey和O'Malley的框架下进行了范围审查.
- 在包括PubMed,Scopus,CINAHL,EconLit和PsycINFO在内的主要数据库中进行了搜索.
- 包括评估以减少HI为重点的公共卫生干预措施的研究.
主要成果:
- 在490篇选的文章中,有19篇符合纳入标准.
- 随机对照试验是最常见的研究设计 (n=10).
- 小组分析 (n=10) 和相互作用术语 (n=5) 是主要的评估方法,但没有一项研究明确使用专门的经济指标来评估HI.
结论:
- 公共卫生干预措施的评估经常忽略了明确测量HI减少.
- 这种监督带有方法风险,可能导致干预,无意中加剧了健康差异.
- 建议系统地整合经济指标 (例如,吉尼指数) 和方法 (例如,分配成本效益分析) 来进行严格的HI评估.
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