Centre for Primary Health Care and Equity, University of New South Wales, Sydney 2052, Australia.
Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh.
Int J Environ Res Public Health. 2022 Aug 1;19(15):9411. doi: 10.3390/ijerph19159411.
The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched , , and using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barriers identified in the review included having digitally literate caregivers present during virtual care appointments, conducting virtual care appointments in culturally sensitive manner, and having a focus on enhancing patients' digital literacy. We identified evidence-based practices for virtual care interventions to ensure equity in access and delivery for their virtual care patients.
本次综述的目的是从全球视角绘制和总结有关虚拟医疗干预措施可及性和实施方面存在的不平等现象的现有证据，并确定虚拟医疗服务可能采用的策略，以解决这些不平等问题。我们使用了 、 和 数据库，使用医学主题词（MeSH）和自由文本关键词搜索了探索虚拟提供的门诊服务中存在的不平等现象的实证研究。共纳入了 41 项研究，其中大多数为横断面设计。使用自定义提取工具提取纳入的研究，并进行描述性分析。综述发现，在文化和少数民族、老年人、社会经济弱势群体、数字和/或健康素养有限以及数字设备和良好连接有限的人群中，虚拟医疗干预措施的可及性和使用方面存在广泛差异。综述中确定的解决这些障碍的潜在解决方案包括在虚拟护理预约期间安排具备数字素养的护理人员、以文化敏感的方式进行虚拟护理预约以及注重提高患者的数字素养。我们确定了虚拟护理干预措施的循证实践，以确保虚拟护理患者获得公平的可及性和实施。
