Centre for Health and Society, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
BMJ Open. 2021 Nov 23;11(11):e054806. doi: 10.1136/bmjopen-2021-054806.
Even in advanced economies with universal healthcare coverage (UHC), a social gradient in healthcare utilisation has been reported. Many individual, community and healthcare system factors have been considered that may be associated with the variation in healthcare utilisation between socioeconomic groups. Nevertheless, relatively little is known about the complex interaction and relative contribution of these factors to socioeconomic differences in healthcare utilisation. In order to improve understanding of why utilisation patterns differ by socioeconomic status (SES), the proposed systematic review will explore the main mechanisms that have been examined in quantitative research.
The systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and will be conducted in Embase, PubMed, Scopus, Web of Science, Econlit and PsycInfo. Articles examining factors associated with the differences in primary and specialised healthcare utilisation between socioeconomic groups in Organisation for Economic Co-operation and Development (OECD) countries with UHC will be included. Further restrictions concern specifications of outcome measures, factors of interest, study design, population, language and type of publication. Data will be numerically summarised, narratively synthesised and thematically discussed. The factors will be categorised according to existing frameworks for barriers to healthcare access.
No primary data will be collected. No ethics approval is required. We intend to publish a scientific article in an international peer-reviewed journal.
即使在具有全民医保覆盖（UHC）的发达经济体中，也有报道称医疗保健的利用存在社会梯度。已经考虑了许多个人、社区和医疗系统因素，这些因素可能与社会经济群体之间医疗保健利用的差异有关。然而，对于这些因素之间复杂的相互作用及其对医疗保健利用的社会经济差异的相对贡献，人们知之甚少。为了更好地理解为什么利用模式会因社会经济地位（SES）而异，拟议的系统评价将探讨在定量研究中已经检查过的主要机制。
系统评价将遵循系统评价和荟萃分析的首选报告项目指南，并将在 Embase、PubMed、Scopus、Web of Science、Econlit 和 PsycInfo 中进行。将包括检查经合组织（OECD）国家全民医保覆盖下社会经济群体之间初级和专科医疗保健利用差异相关因素的文章。进一步的限制涉及结果衡量标准、感兴趣因素、研究设计、人口、语言和出版物类型的具体规定。数据将以数字方式汇总、叙述性综合和主题性讨论。这些因素将根据现有的医疗保健获取障碍框架进行分类。
不会收集原始数据。不需要伦理批准。我们打算在国际同行评议期刊上发表一篇科学文章。
