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衡量社会决定因素对患者预后的影响:一项系统文献综述。

Measuring the Effect of Social Determinants on Patient Outcomes: A Systematic Literature Review.

作者信息

Knighton Andrew J, Stephenson Brad, Savitz Lucy A

出版信息

J Health Care Poor Underserved. 2018;29(1):81-106. doi: 10.1353/hpu.2018.0009.

Abstract

Given the movement towards value-based purchasing in the United States, health care leaders need methods to characterize and address the complex effect that social determinants have on health care outcomes. This systematic literature review was specifically designed to understand current research on the effect that patient material and social deprivation has on health care delivery outcomes and the potential benefit of clinical interventions designed to mediate this effect. A total of 310 studies were identified for review with 80 studies included in the final synthesis. Results highlight significant variation in the methods used to measure the effect of social determinants on health care outcomes and the need for common measurement standards. More robust identification of deprivation-sensitive diseases or conditions is needed to channel scarce program resources to effected conditions. Finally, further research is needed to evaluate the benefits of data-driven, tailored clinical interventions designed to serve the needs of materially-deprived patient populations.

摘要

鉴于美国正朝着基于价值的采购方向发展,医疗保健领导者需要方法来描述和解决社会决定因素对医疗保健结果产生的复杂影响。这项系统的文献综述专门旨在了解当前关于患者物质和社会剥夺对医疗保健提供结果的影响以及旨在调节这种影响的临床干预措施的潜在益处的研究。总共确定了310项研究进行综述,最终综合纳入了80项研究。结果突出了用于衡量社会决定因素对医疗保健结果影响的方法存在显著差异,以及需要通用的测量标准。需要更有力地识别对剥夺敏感的疾病或状况,以便将稀缺的项目资源导向受影响的状况。最后,需要进一步研究来评估旨在满足物质匮乏患者群体需求的数据驱动型、量身定制的临床干预措施的益处。

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