Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.
Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.
PLoS One. 2019 Mar 20;14(3):e0213845. doi: 10.1371/journal.pone.0213845. eCollection 2019.
Free provision of tangible goods that may improve health is one approach to addressing discrepancies in health outcomes related to income, yet it is unclear whether providing goods for free improves health. We systematically reviewed the literature that reported the association between the free provision of tangible goods and health outcomes.
A search was performed for relevant literature in all languages from 1995-May 2017. Eligible studies were observational and experimental which had at least one tangible item provided for free and had at least one quantitative measure of health. Studies were excluded if the intervention was primarily a service and the free good was relatively unimportant; if the good was a medication; or if the data in a study was duplicated in another study. Covidence screening software was used to manage articles for two levels of screening. Data was extracted using an adaption of the Cochrane data collection template. Health outcomes, those that affect the quality or duration of life, are the outcomes of interest. The study was registered with PROSPERO (CRD42017069463).
The initial search identified 3370 articles and 59 were included in the final set with a range of 20 to 252 246 participants. The risk of bias assessment revealed that overall, the studies were of medium to high quality. Among the studies included in this review, 80 health outcomes were statistically significant favouring the intervention, 19 health outcomes were statistically significant favouring the control, 141 health outcomes were not significant and significance was unknown for 28 health outcomes.
The results of this systematic review provide evidence that free goods can improve health outcomes in certain circumstances, although there were important gaps and limitations in the existing literature.
提供有形物品以改善健康是解决与收入相关的健康结果差异的一种方法，但目前尚不清楚免费提供物品是否能改善健康。我们系统地回顾了报告免费提供有形物品与健康结果之间关系的文献。
使用所有语言从 1995 年 5 月至 2017 年 5 月进行了相关文献检索。合格的研究为观察性和实验性研究，这些研究至少有一项免费提供的有形物品，并且至少有一项健康的定量测量。如果干预主要是服务，免费的物品相对不重要；如果物品是药物；或者研究中的数据在另一项研究中重复，则将排除该研究。Covidence 筛选软件用于对两个层次的文章进行管理。使用 Cochrane 数据收集模板的改编版提取数据。健康结果是指影响生活质量或寿命的结果。该研究已在 PROSPERO（CRD42017069463）上注册。
最初的搜索确定了 3370 篇文章，其中 59 篇文章被纳入最终研究，参与者范围从 20 人到 252246 人不等。偏倚风险评估显示，总体而言，这些研究的质量为中等到高度。在本综述中包括的研究中，有 80 个健康结果具有统计学意义，有利于干预组，19 个健康结果具有统计学意义，有利于对照组，141 个健康结果无统计学意义，28 个健康结果的意义未知。
这项系统评价的结果提供了证据表明，在某些情况下，免费的物品可以改善健康结果，尽管现有文献存在重要的差距和局限性。
