Rolnitsky Asaph, Kirtsman Maksim, Goldberg Hanna R, Dunn Michael, Bell Chaim M
Department of Paediatrics, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
Department of Paediatrics, Neonatology Division, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
Int J Qual Health Care. 2018 May 1;30(4):244-249. doi: 10.1093/intqhc/mzy016.
A mapping review to quantify representation of vulnerable populations, who suffer from disparity and often inequitable healthcare, in quality improvement (QI) research.
Studies published in 2004-2014 inclusive from Medline, Embase and Cochrane databases for English language research with the terms 'quality improvement' or 'quality control' or 'QI' and 'plan-do-study-act' or 'PDSA' in the years 2004-2014 inclusively.
Published clinical research that was a QI-themed, as identified by its declared search terms, MESH terms, abstract or title.
Three reviewers identified the eligible studies independently. Excluded were publications that were not trials, evaluations or analyses.
Of 2039 results, 1660 were eligible for inclusion. There were 586 (33.5%) publications that targeted a specific vulnerable population: children (184, 10.54%), mental health patients (125, 7.16%), the elderly (100, 5.73%), women (57, 3.27%), the poor (30, 1.72%), rural residents (29, 1.66%), visible minorities (27, 1.55%), the terminally ill (17, 0.97%), adolescents (16, 0.92%) and prisoners (1 study). Seventy-four articles targeted two or more vulnerable populations, and 11 targeted three population categories. On average, there were 158 QI research studies published per year, increasing from 69 in 2004 to 396 in 2014 (R2 = 0.7, P < 0.001). The relative representation of vulnerable populations had a mean of 33.58% and was stable over the time period (standard deviation (SD) = 5.9%, R2 = 0.001). Seven countries contributed to over 85% of the publications targeting vulnerable populations, with the USA contributing 62% of the studies.
Over 11 years, there has been a marked increase in QI publications. Roughly one-third of all published QI research is on vulnerable populations, a stable proportion over time. Nevertheless, some vulnerable populations are under-represented. Increased education, resources and attention are encouraged to improve the health of vulnerable populations through focused QI initiatives.
进行一项映射综述，以量化弱势群体在质量改进（QI）研究中的代表性，这些群体面临医疗保健差异且往往不公平。
2004年至2014年期间发表在Medline、Embase和Cochrane数据库中的英文研究，搜索词为2004年至2014年期间的“质量改进”或“质量控制”或“QI”以及“计划-执行-研究-行动”或“PDSA”。
已发表的以QI为主题的临床研究，通过其声明的搜索词、医学主题词、摘要或标题来确定。
三位评审员独立确定符合条件的研究。排除非试验、评估或分析的出版物。
在2039项结果中，1660项符合纳入条件。有586项（33.5%）出版物针对特定弱势群体：儿童（184项，10.54%）、精神卫生患者（125项，7.16%）、老年人（100项，5.73%）、女性（57项，3.27%）、贫困人口（30项，1.72%）、农村居民（29项，1.66%）、可见少数群体（27项，1.55%）、绝症患者（17项，0.97%）、青少年（16项，0.92%）和囚犯（1项研究）。74篇文章针对两个或更多弱势群体，11篇针对三个群体类别。平均每年发表158项QI研究，从2004年的69项增加到2014年的396项（R2 = 0.7，P < 0.001）。弱势群体的相对代表性平均为33.58%，在该时间段内保持稳定（标准差（SD）= 5.9%，R2 = 0.001）。七个国家贡献了超过85%的针对弱势群体的出版物，其中美国贡献了62%的研究。
在11年中，QI出版物显著增加。所有已发表的QI研究中约有三分之一是关于弱势群体的，这一比例随时间保持稳定。然而，一些弱势群体的代表性不足。鼓励通过有针对性的QI举措增加教育、资源和关注，以改善弱势群体的健康状况。
