Department of Health Services Management, Ludwig-Maximilians-University Munich, Munich, Germany
Chair of Health Economics, Technical University of Munich, Munich, Germany.
BMJ Open. 2021 Feb 5;11(2):e044301. doi: 10.1136/bmjopen-2020-044301.
Although the impact of macrolevel characteristics of health systems on socioeconomic inequity in health has been studied extensively, the impact of access characteristics on a smaller scale of health systems has received less attention. These mesolevel characteristics can influence access to healthcare and might have the potential to moderate or aggravate socioeconomic inequity in healthcare use. This scoping review aims to map the existing evidence of the association of socioeconomic inequity in healthcare use and mesolevel access characteristics of the health system.
In conducting the scoping review, we follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews. The search will be carried out in four scientific databases: MEDLINE (via PubMed), Web of Science, Scopus and PsycINFO. Main eligibility criteria are inclusion in the analysis of a measure of socioeconomic position, a measure of individual healthcare use and a mesolevel determinant of access to healthcare services. The selection process consists of two consecutive screening stages (first: title/abstract; second: full text). At both stages, two reviewers independently assess the eligibility of studies. In case of disagreement, a third reviewer will be involved. Cohen's kappa will be calculated to report inter-rater agreement between reviewers. Results are synthesised narratively, as a high heterogeneity of studies is expected.
No primary data are collected for the presented scoping review. Therefore, ethical approval is not necessary. The scoping review will be published in an international peer-reviewed journal, and findings will be presented on national and international conferences.
尽管健康系统的宏观层面特征对健康的社会经济不平等的影响已得到广泛研究，但健康系统较小规模的准入特征的影响却较少受到关注。这些中观层面的特征可能会影响医疗保健的获取，并有可能调节或加剧医疗保健使用方面的社会经济不平等。本范围界定综述旨在绘制现有证据，以说明医疗保健使用的社会经济不平等与健康系统的中观层面准入特征之间的关联。
在进行范围界定综述时，我们遵循系统评价和荟萃分析报告的首选报告项目扩展用于范围界定综述。搜索将在四个科学数据库中进行：MEDLINE（通过 PubMed）、Web of Science、Scopus 和 PsycINFO。主要入选标准是纳入社会经济地位的衡量指标、个体医疗保健使用的衡量指标以及医疗服务准入的中观层面决定因素的分析。选择过程包括两个连续的筛选阶段（第一阶段：标题/摘要；第二阶段：全文）。在这两个阶段，两名评审员独立评估研究的合格性。如果存在分歧，将邀请第三名评审员参与。将计算 Cohen's kappa 以报告评审员之间的评分者间一致性。由于预计研究之间存在高度异质性，因此将以叙述性方式综合结果。
本范围界定综述不收集原始数据。因此，不需要伦理批准。该范围界定综述将在国际同行评议期刊上发表，并将在国家和国际会议上介绍研究结果。
