建模医疗保健设施接入的综合指数的方法:系统文献审查
Moses M Musau1,2,3, Ann Njogu4, Alex Maina5
1Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Nairobi, Kenya. mmusau@kemri-wellcome.org.
Population health metrics
|November 22, 2025
概括
衡量医疗保健的准入是复杂的. 本综述综合了多维复合指数的方法,强调了需要明确的框架和特定背景的权重,以改善全球医疗保健准入评估.
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
- 医疗保健管理的管理
背景情况:
- 全民健康覆盖 (UHC) 依赖于获得优质医疗保健.
- 量化多维访问 (可用性,可访问性,适应性,可负担性,可接受性) 是一个挑战.
- 现有的方法往往侧重于单个维度,限制了全面的评估.
研究的目的:
- 系统地审查用于构建医疗保健设施准入的多维复合指数的方法方法和数据.
- 综合对医疗保健准入指数的定义,数据源,指标表示,权重技术和聚合方法的发现.
主要方法:
- 在八个数据库 (如PubMed,Scopus,Web of Science) 进行系统的文献审查.
- 遵守系统审查 (PRISMA) 准则的优先报告项目.
- 包括使用多个访问维度构建复合索引的研究,然后进行质量评估和专题分析.
主要成果:
- 19项研究符合纳入标准,最近 (2021-2024) 在印度和美国进行的大部分研究;没有在非洲进行的.
- 复合指数在所包含的维度数量 (2-5个) 中有所不同,其中负担能力是最常见的 (84%).
- 在定义,数据源,指标表示,权重 (例如PCA,AHP) 和聚合方法 (例如算术平均值,总和) 中观察到显著的异质性.
结论:
- 为了评估多维的医疗保健准入,存在不同的方法.
- 未来的复合指数需要明确定义的框架和特定环境的维度权重.
- 建议采用惩罚性聚合方法来进行可靠和全面的医疗保健准入评估.
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