Assessing healthcare access using the Levesque's conceptual framework- a scoping review.
Assessing healthcare access using the Levesque's conceptual framework- a scoping review.
复制标题
DOI：
10.1186/s12939-021-01416-3
复制
发表时间：
2021-05-07
影响因子：
4.8
通讯作者：
Ridde V
中科院分区：
文献类型：
--
作者：
Cu A;Meister S;Lefebvre B;Ridde V
各国正在努力通过全民医疗保险改善获得医疗保健的机会。为了真正解决医疗保健可及性问题，我们需要认识到医疗保健可及性的所有层面和复杂性。Levesque在2013年推出的《健康可及性概念框架》通过五个可及性维度和人口获得医疗保健的五种能力提供了一个有趣而全面的视角。本文的目标是识别和分析所有的实证研究，应用Levesque的概念框架获得医疗保健，并探讨经验和挑战的研究人员使用这个框架开发工具，评估访问。通过搜索四个数据库进行范围审查，寻找引用Levesque等人2013年的研究，以选择应用该框架的所有专注于医疗保健获取的实证研究。最初的1838份文件进行了标题筛选，其次是摘要筛选，最后由两名独立的审查员进行全文筛选。还采访了从范围审查中确定的研究作者。有31项研究使用Levesque框架确定了医疗保健可及性，无论是先验的，开发评估工具（11项研究），还是事后的，组织和分析收集的数据（20项研究）。从所使用的工具中，收集了147个关于医疗保健获取的独特问题，其中91个探索了获取的维度，而56个是关于获取的能力。从病人的角度设计的占73%，而20%是为医疗服务提供者设计的，7%是针对两者的。对26名作者中的7名作者的访谈表明，虽然存在一些挑战，如分类困难和各方面和能力代表性不平等的情况，但总体经验是积极的。Levesque的框架已成功地用于探索，评估和测量各种医疗服务和环境的研究。该框架使研究人员能够全面评估卫生系统和人口背景下复杂和动态的获取过程。该框架仍有改进的余地，特别是在纳入与时间有关的准入要素方面。在线版本包含补充材料，可通过10.1186/s12939-021-01416-3获得。
Countries are working hard to improve access to healthcare through Universal Healthcare Coverage. To genuinely address the problems of healthcare access, we need to recognize all the dimensions and complexities of healthcare access. Levesque’s Conceptual Framework of Access to Health introduced in 2013 provides an interesting and comprehensive perspective through the five dimensions of access and the five abilities of the population to access healthcare. The objectives of this paper are to identify and analyze all empirical studies that applied Levesque’s conceptual framework for access to healthcare and to explore the experiences and challenges of researchers who used this framework in developing tools for assessing access. A scoping review was conducted by searching through four databases, for studies citing Levesque et al. 2013 to select all empirical studies focusing on healthcare access that applied the framework. An initial 1838 documents underwent title screening, followed by abstract screening, and finally full text screening by two independent reviewers. Authors of studies identified from the scoping review were also interviewed. There were 31 studies identified on healthcare access using the Levesque framework either a priori, to develop assessment tool/s (11 studies), or a posteriori, to organize and analyze collected data (20 studies). From the tools used, 147 unique questions on healthcare access were collected, 91 of these explored dimensions of access while 56 were about abilities to access. Those that were designed from the patient’s perspective were 73%, while 20% were for health providers, and 7% were addressed to both. Interviews from seven out of the 26 authors, showed that while there were some challenges such as instances of categorization difficulty and unequal representation of dimensions and abilities, the overall experience was positive. Levesque’s framework has been successfully used in research that explored, assessed, and measured access in various healthcare services and settings. The framework allowed researchers to comprehensively assess the complex and dynamic process of access both in the health systems and the population contexts. There is still potential room for improvement of the framework, particularly the incorporation of time-related elements of access. The online version contains supplementary material available at 10.1186/s12939-021-01416-3.
登录
查看更多内容
DOI：
10.1016/s0140-6736(18)31668-4
发表时间：
2018-11-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Kruk ME;Gage AD;Joseph NT;Danaei G;García-Saisó S;Salomon JA
通讯作者：
Salomon JA
影响因子：
2.9
作者：
Bailie J;Schierhout G;Laycock A;Kelaher M;Percival N;O'Donoghue L;McNeair T;Bailie R
通讯作者：
Bailie R
影响因子：
3
作者：
ADAY, LA;ANDERSEN, RM
通讯作者：
ANDERSEN, RM
影响因子：
3.2
作者：
Henry, Julia;Beruf, Christian;Fischer, Thomas
通讯作者：
Fischer, Thomas
影响因子：
3.2
作者：
Jacobs, Bart;Ir, Por;Van Damme, Wim
通讯作者：
Van Damme, Wim