Understanding primary care transformation and implications for ageing populations and health inequalities: a systematic scoping review of new models of primary health care in OECD countries and China.
Understanding primary care transformation and implications for ageing populations and health inequalities: a systematic scoping review of new models of primary health care in OECD countries and China.
复制标题
DOI：
10.1186/s12916-023-03033-z
复制
发表时间：
2023-08-24
期刊：
影响因子：
9.3
通讯作者：
Mercer, S. W.
中科院分区：
文献类型：
--
作者：
Henderson, D. A. G.;Donaghy, E.;Dozier, M.;Guthrie, B.;Huang, H.;Pickersgill, M.;Stewart, E.;Thompson, A.;Wang, H. H. X.;Mercer, S. W.
许多国家都进行了旨在实现初级保健转型的改革。共同目标包括应对与人口老龄化和健康不平等相关的服务提供挑战。迄今为止，很少有研究比较PCT国际。我们的目的是通过对国际文献进行系统的范围界定审查来研究PCT和初级保健的新模式，以描述主要的政策变化，包括关键的“组成部分”，新模式的影响，以及PCT实施的障碍和促进因素。我们对OECD国家和中国的PCT国际文献进行了系统的范围审查（已发表的方案：https：//osf.io/2afym）。检索了奥维德[MEDLINE/Embase/Global Health]、CINAHL Plus和Global Index Medicus（01/01/10至28/08/21）。两名评审员独立筛选标题和摘要，由一名评审员进行数据提取。随后对调查结果进行了叙述性综合。共纳入了来自15个国家的107项研究。PCT最常采用的组成部分是多学科团队（MDT）的扩展（46%的研究）。最常测量的结果是GP视图（27%），< 20%测量患者视图或满意度。只有3项研究评估了PCT对老龄化人口的影响，34项（32%）评估了健康不平等的影响，结果不明确。对于后者，涉及增加初级保健可及性的PCT显示出积极影响，而其他组成部分没有报告任何益处。对引用PCT实施障碍或促进因素的41项研究进行分析，确定领导力、变革、资源和目标为关键主题。本次审查中确定的国家对PCT采用了一系列方法，但评价方法明显不同，影响结果也参差不齐。只有少数研究描述了PCT对老龄化人口、健康不平等或从患者角度的影响。查明的促进因素和障碍可能有助于规划和评估PCT的未来发展。在线版本包含补充材料，可通过10.1186/s12916-023-03033-z获得。
Many countries have introduced reforms with the aim of primary care transformation (PCT). Common objectives include meeting service delivery challenges associated with ageing populations and health inequalities. To date, there has been little research comparing PCT internationally. Our aim was to examine PCT and new models of primary care by conducting a systematic scoping review of international literature in order to describe major policy changes including key ‘components’, impacts of new models of care, and barriers and facilitators to PCT implementation. We undertook a systematic scoping review of international literature on PCT in OECD countries and China (published protocol: https://osf.io/2afym). Ovid [MEDLINE/Embase/Global Health], CINAHL Plus, and Global Index Medicus were searched (01/01/10 to 28/08/21). Two reviewers independently screened the titles and abstracts with data extraction by a single reviewer. A narrative synthesis of findings followed. A total of 107 studies from 15 countries were included. The most frequently employed component of PCT was the expansion of multidisciplinary teams (MDT) (46% of studies). The most frequently measured outcome was GP views (27%), with < 20% measuring patient views or satisfaction. Only three studies evaluated the effects of PCT on ageing populations and 34 (32%) on health inequalities with ambiguous results. For the latter, PCT involving increased primary care access showed positive impacts whilst no benefits were reported for other components. Analysis of 41 studies citing barriers or facilitators to PCT implementation identified leadership, change, resources, and targets as key themes. Countries identified in this review have used a range of approaches to PCT with marked heterogeneity in methods of evaluation and mixed findings on impacts. Only a minority of studies described the impacts of PCT on ageing populations, health inequalities, or from the patient perspective. The facilitators and barriers identified may be useful in planning and evaluating future developments in PCT. The online version contains supplementary material available at 10.1186/s12916-023-03033-z.
登录
查看更多内容
影响因子：
4
作者：
Brown EA;White BM;Jones WJ;Gebregziabher M;Simpson KN
通讯作者：
Simpson KN
影响因子：
2.8
作者：
Huang Y;Jiang Y;Zhang L;Mao W;van Boven JFM;Postma MJ;Chen W
通讯作者：
Chen W
DOI：
10.3390/ijerph17051782
发表时间：
2020-03-01
影响因子：
--
作者：
Chen, Jiaqi;Xu, Song;Gao, Jing
通讯作者：
Gao, Jing
影响因子：
5.7
作者：
Bidassie, Balmatee;Davies, Michael L.;Boushon, Barbara
通讯作者：
Boushon, Barbara
DOI：
10.34172/ijhpm.2021.42
发表时间：
2022-01-01
影响因子：
3.5
作者：
Baum, Fran;Freeman, Toby
通讯作者：
Freeman, Toby