Sociodemographic Disparities in Access to Hospice and Palliative Care: An Integrative Review.
Sociodemographic Disparities in Access to Hospice and Palliative Care: An Integrative Review.
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DOI：
10.1177/1049909120985419
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Davidson PM
中科院分区：
文献类型：
--
作者：
Nelson KE;Wright R;Peeler A;Brockie T;Davidson PM
越来越多的证据表明，社会人口群体在获得临终关怀和姑息治疗服务方面存在不同程度的差异。造成准入问题的根本因素很少受到系统性的关注。为了综合当前关于获得临终关怀和姑息治疗方面的差异的文献，强调受这些不平等影响的社会人口群体的范围，描述所涉及的获得领域的特征，并概述对研究、政策和临床实践的影响。一项综合审查包括对 PubMed、Embase 和 CINAHL 数据库的系统检索，该检索从开始到 2020 年 3 月进行，旨在概述美国临终关怀和姑息治疗方面存在的差异。在医疗保健可及性概念框架的背景下，使用关键综合来分析数据。纳入的研究对方法学质量和报告质量进行了评估。在纳入的文章中，80% 采用非实验研究设计。研究指标各不相同，但 70% 的研究描述了种族、民族或社会经济地位的结果差异。其他人则揭示了基于年龄、性别和地理位置等变量的不同访问权限。总体综合突出了跨越 5 个访问领域的差异证据：平易近人性、可接受性、可用性、可负担性和适当性； 60% 的研究主要强调可接受性、可负担性和适当性。这种综合审查强调需要考虑未来个人、提供商和系统层面的各种利益相关者的观点和态度，以瞄准和解决跨越所有领域的访问问题。
There is growing evidence of disparities in access to hospice and palliative care services to varying degrees by sociodemographic groups. Underlying factors contributing to access issues have received little systematic attention. To synthesize current literature on disparities in access to hospice and palliative care, highlight the range of sociodemographic groups affected by these inequities, characterize the domains of access addressed, and outline implications for research, policy, and clinical practice. An integrative review comprised a systematic search of PubMed, Embase, and CINAHL databases, which was conducted from inception to March 2020 for studies outlining disparities in hospice and palliative care access in the United States. Data were analyzed using critical synthesis within the context of a health care accessibility conceptual framework. Included studies were appraised on methodological quality and quality of reporting. Of the articles included, 80% employed non-experimental study designs. Study measures varied, but 70% of studies described differences in outcomes by race, ethnicity, or socioeconomic status. Others revealed disparate access based on variables such as age, gender, and geographic location. Overall synthesis highlighted evidence of disparities spanning 5 domains of access: Approachability, Acceptability, Availability, Affordability, and Appropriateness; 60% of studies primarily emphasized Acceptability, Affordability, and Appropriateness. This integrative review highlights the need to consider various stakeholder perspectives and attitudes at the individual, provider, and system levels going forward, to target and address access issues spanning all domains.
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影响因子：
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作者：
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