学术健康中心在构建公平卫生系统中的作用：一项系统评价方案

The role of academic health centres in building equitable health systems: a systematic review protocol.

作者信息

Edelman Alexandra, Taylor Judy, Ovseiko Pavel V, Topp Stephanie M

机构信息

College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Queensland, Australia.

Tropical Australian Academic Health Centre, Queensland, Australia.

出版信息

BMJ Open. 2017 May 29;7(5):e015435. doi: 10.1136/bmjopen-2016-015435.

DOI:10.1136/bmjopen-2016-015435

PMID:28554932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5730009/

Abstract

INTRODUCTION

Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the role of AHCs in contributing to equitable health systems locally and globally.

METHODS AND ANALYSIS

Electronic searches will be conducted on a pilot list of bibliographic databases, including Google Scholar, Scopus, MEDLINE, PsycInfo, CINAHL, ERIC, ProQuest Dissertations & Theses, Cochrane Library, Evidence Based Medicine Reviews, Campbell Library and A+ Education, from 1 January 2000 to 31 December 2016. Apart from studies reporting clinical interventions or trials, all types of published peer-reviewed and grey literature will be included in the review. The single screening method will be employed in selecting studies, with two additional reviewers consulted where allocation is unclear. Quality and relevance appraisal utilising Joanna Briggs Institute critical appraisal tools will follow data extraction to a preprepared template. Thematic synthesis will be undertaken to develop descriptive themes and inform analysis.

ETHICS AND DISSEMINATION

As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications as well as presentations at relevant national and international conferences. Results will be further disseminated through networks and associations of AHCs.

PROTOCOL REGISTRATION

International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016051802.

摘要

引言

学术健康中心（AHCs）是复杂的组织，通常由其“三方”使命来定义：实现高标准的临床护理、开展临床和实验室研究以及培养卫生专业人员。在过去十年中，学术健康中心已从主要关注针对个体的高影响力（临床）干预措施，转向更注重人群的范式，这需要网络化的机构，并对一系列问题做出响应，包括健康结果的分布和健康决定因素。这种范式转变的一个体现是，人们越来越关注学术健康中心在解决健康差距和改善卫生系统公平性方面的作用。本方案概述了一项系统评价，旨在综合并批判性地评估关于学术健康中心在促进本地和全球卫生系统公平性方面作用的现有证据状况。

方法与分析

将对一系列文献数据库进行电子检索，包括谷歌学术、Scopus、MEDLINE、PsycInfo、CINAHL、ERIC、ProQuest学位论文数据库、Cochrane图书馆、循证医学综述、坎贝尔图书馆和A+教育数据库，检索时间范围为2000年1月1日至2016年12月31日。除了报告临床干预措施或试验的研究外，所有类型的已发表同行评审文献和灰色文献都将纳入本综述。在选择研究时将采用单轮筛选方法，在分配不明确时咨询另外两名评审人员。在将数据提取到预先准备好的模板后，将使用乔安娜·布里格斯研究所的批判性评价工具进行质量和相关性评估。将进行主题综合以形成描述性主题并为分析提供信息。