在审计和反试验中探索公平:对系统审查的二次分析
Zeenat Ladak1,2, Camille Williams2, Tolulope Ojo1
1University of Toronto, Toronto, Ontario, Canada.
PloS one
|March 9, 2026
概括
审计和反 (A&F) 试验很少解决健康公平问题. 未来的A&F研究应该包含明确的公平干预措施,以减少医疗保健差异并改善所有人群的结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
- 卫生公平研究 卫生公平研究
背景情况:
- 审计和反 (A&F) 是通过向临床医生提供绩效数据来提高医疗保健质量的战略.
- 通过突出对弱势群体的护理差异,A&F有潜力减少健康不平等.
- 在何种程度上,A&F干预措施在设计和评估时考虑到健康公平性,这一点尚不清楚.
研究的目的:
- 检查评估A&F干预措施的随机对照试验在多大程度上解决了健康公平问题.
- 使用PROGRESS-Plus框架将A&F试验根据其对健康公平的倾向进行分类.
主要方法:
- 来自A&F. Cochrane系统审查的271个随机对照试验的二次分析.
- 应用PROGRESS-Plus框架来评估包含与股权相关的变量.
- 研究的分类为非股权导向,股权信息或股权专注.
主要成果:
- 44%的试验不是以公平为导向的,35%是以公平为导向的,21%是以公平为导向的.
- 股权知情和股权专注试验的比例随着时间的推移而增加.
- 很少有试验明确报告了嵌入股权考虑或使用以股权为导向的框架; 共同的 PROGRESS-Plus 因素包括年龄,保险,居住地和性别/性别.
结论:
- A&F试验很少检查或报告健康公平性在其设计,流程,分析或解释中的整合.
- 未来的A&F试验需要明确测试将股权相关干预措施纳入的方法.
- 未来的研究应该旨在通过A&F提高人们对护理不当差异的认识,并解决这些不当差异.
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