Health system responsiveness: a systematic evidence mapping review of the global literature.
Health system responsiveness: a systematic evidence mapping review of the global literature.
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DOI：
10.1186/s12939-021-01447-w
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发表时间：
2021-05-01
影响因子：
4.8
通讯作者：
Olivier J
中科院分区：
文献类型：
--
作者：
Khan G;Kagwanja N;Whyle E;Gilson L;Molyneux S;Schaay N;Tsofa B;Barasa E;Olivier J
世界卫生组织将响应能力、公平筹资和公平作为卫生系统的内在目标。然而，在这三者中，响应性受到的关注明显较少。响应能力对加强系统运作至关重要；提供公平和负责任的服务；并保护公民的权利。迫切需要提高系统的响应能力，但我们对响应能力的理解有限。因此，我们试图绘制卫生系统反应性的现有证据。采用混合方法进行系统化证据图谱评价。我们搜索了PubMed， EbscoHost和b谷歌Scholar。已发表文献和灰色文献；概念性和经验性出版物；出版于2000年至2020年之间，包括英语文本。我们筛选了1119篇出版物的标题和摘要以及870篇全文。该综述包括621份出版物。证据图谱显示，2011年至2020年期间（n = 462/621）的出版物比早期多得多。大多数出版物来自欧洲（n = 139），高收入国家（n = 241）的出版物多于中低收入国家（n = 217）。实证研究（n = 424/621）多采用定量方法（n = 232），定性方法（n = 127）和混合方法（n = 63）较为少见。专题分析揭示了“卫生系统响应性”的八个主要概念，可分为三个主要类别：1)单向用户服务界面；2)作为用户与卫生系统之间反馈循环的响应性；3)响应性是公众和系统之间的问责制。这张证据图显示了大量关于卫生系统反应能力的现有文献，但也揭示了需要进一步发展的证据差距，包括：反应能力的明确定义和理论体系；反馈回路的实施和有效性；系统对这个反馈作出反应；具体情况下的机制实施经验，特别是低收入和中等收入国家以及脆弱和受冲突影响国家的经验；以及与卫生公平、少数群体和弱势群体有关的反应能力。理论发展是必要的，我们建议分离服务和系统响应的概念，在未来的工作中应用更强的系统视角。建议进一步制定议程并为卫生系统反应能力方面的过渡性工作提供资源。在线版本包含补充材料，可在10.1186/s12939-021-01447-w获得。
The World Health Organisation framed responsiveness, fair financing and equity as intrinsic goals of health systems. However, of the three, responsiveness received significantly less attention. Responsiveness is essential to strengthen systems’ functioning; provide equitable and accountable services; and to protect the rights of citizens. There is an urgency to make systems more responsive, but our understanding of responsiveness is limited. We therefore sought to map existing evidence on health system responsiveness. A mixed method systemized evidence mapping review was conducted. We searched PubMed, EbscoHost, and Google Scholar. Published and grey literature; conceptual and empirical publications; published between 2000 and 2020 and English language texts were included. We screened titles and abstracts of 1119 publications and 870 full texts. Six hundred twenty-one publications were included in the review. Evidence mapping shows substantially more publications between 2011 and 2020 (n = 462/621) than earlier periods. Most of the publications were from Europe (n = 139), with more publications relating to High Income Countries (n = 241) than Low-to-Middle Income Countries (n = 217). Most were empirical studies (n = 424/621) utilized quantitative methodologies (n = 232), while qualitative (n = 127) and mixed methods (n = 63) were more rare. Thematic analysis revealed eight primary conceptualizations of ‘health system responsiveness’, which can be fitted into three dominant categorizations: 1) unidirectional user-service interface; 2) responsiveness as feedback loops between users and the health system; and 3) responsiveness as accountability between public and the system. This evidence map shows a substantial body of available literature on health system responsiveness, but also reveals evidential gaps requiring further development, including: a clear definition and body of theory of responsiveness; the implementation and effectiveness of feedback loops; the systems responses to this feedback; context-specific mechanism-implementation experiences, particularly, of LMIC and fragile-and conflict affected states; and responsiveness as it relates to health equity, minority and vulnerable populations. Theoretical development is required, we suggest separating ideas of services and systems responsiveness, applying a stronger systems lens in future work. Further agenda-setting and resourcing of bridging work on health system responsiveness is suggested. The online version contains supplementary material available at 10.1186/s12939-021-01447-w.
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DOI：
10.2471/blt.07.050401
发表时间：
2009-04-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Bleich, Sara N;Özaltin, Emre;Murray, Christopher JL
通讯作者：
Murray, Christopher JL
影响因子：
2.4
作者：
Atherton, Helen;Fleming, Joanna;Powell, John
通讯作者：
Powell, John
影响因子：
2.8
作者：
Atela, Martin;Bakibinga, Pauline;Cohn, Simon
通讯作者：
Cohn, Simon
DOI：
10.1111/hex.12298
发表时间：
2015-12
期刊：
Health expectations : an international journal of public participation in health care and health policy
影响因子：
--
作者：
Boiko O;Campbell JL;Elmore N;Davey AF;Roland M;Burt J
通讯作者：
Burt J
影响因子：
2.2
作者：
Baldie DJ;Guthrie B;Entwistle V;Kroll T
通讯作者：
Kroll T