农村和偏远地区基于证据的医疗保健干预措施的实施策略:范围审查
Anna Chapman1, Cadeyrn J Gaskin2, Hannah Beks3
1Centre for Quality and Patient Safety Research, Institute for Health Transformation, Office of the Executive Dean Health, Faculty of Health, Deakin University, Victoria, Australia.
The Lancet regional health. Western Pacific
|February 6, 2026
概括
在农村地区实施医疗保健干预措施时,经常使用以提供者为中心的策略. 为了减少健康差异,具体的设计和社区参与对于有效实施至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
- 实施科学 实施科学
背景情况:
- 与城市同行相比,农村和偏远地区的人口面临着严重的医疗保健准入和结果差异.
- 有效的实施策略对于转化基于证据的医疗保健干预措施和减少这些不平等至关重要.
- 了解如何在农村和偏远环境中应用和调整战略至关重要,但仍然不清楚.
研究的目的:
- 综合有关高收入国家农村和偏远地区医疗保健干预措施实施战略的证据.
- 确定共同的实施方法及其适应特定的农村环境.
- 突出差距,并为优化服务不足地区的医疗保健实施提供建议.
主要方法:
- 进行了全面的范围审查,搜索了五个主要数据库 (Ovid MEDLINE,Embase,Cochrane CENTRAL,CINAHL,Web of Science).
- 包括2000年1月1日至2024年10月25日期间发表的同行评审研究.
- 从78篇论文 (75项研究) 的数据进行了描述性合成.
主要成果:
- 实施努力是多方面的,经常使用策略,如"培训和教育利益相关者" (93%),"使用评估和代策略" (73%),和"发展利益相关者相互关系" (64%).
- 只有28%的研究报告了农村特定的设计特征.
- 主要关注的是提供者层面的策略,对系统层面的决定因素的关注较少.
结论:
- 优化农村和偏远地区的实施需要特定的背景设计和与当地社区和利益相关者有意义的参与.
- 需要在提供者层面的策略之外,解决系统层面的决定因素.
- 为了减少农村和城市的健康差异,对实施战略及其调整进行更清晰的报告至关重要.
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