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联合健康专业人员:对抗健康不平等工作中的一个有前途的盟友——一项快速综述。

Allied health professionals: A promising ally in the work against health inequalities- A rapid review.

作者信息

Gkiouleka A, Aquino M R J, Ojo-Aromokudu O, van Daalen K R, Kuhn I L, Turner-Moss E, Thomas K, Barnard R, Strudwick R, Ford J

机构信息

Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom.

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.

出版信息

Public Health Pract (Oxf). 2022 May 7;3:100269. doi: 10.1016/j.puhip.2022.100269. eCollection 2022 Jun.

Abstract

OBJECTIVES

Allied Health Professionals (AHPs) have a crucial role in reducing health inequalities. However, there is a lack of evidence regarding the ways they can fulfil this role. This rapid review explores the ways in which AHPs can decrease health care or health outcome inequalities; address inequalities in the social determinants of health; and support disadvantaged groups at an individual, organisational and system level.

STUDY DESIGN

Rapid review following Cochrane criteria and narrative synthesis.

METHODS

MEDLINE, EMBASE, CINAHL, Web of Science and AMED were searched combined with grey literature, to identify quantitative or qualitative review articles published between January 2010 and February 2021.

RESULTS

From 8727 references, 36 met the inclusion criteria. The methodological quality of the studies was assessed with the AMSTAR tool and was generally low. Meta-analysis was not possible due to the heterogeneity of the studies, and a narrative synthesis was produced. Three themes emerged at patient and organisational level: 1) access to AHP services; 2) quality of care; and 3) social determinants of health. Two themes emerged at system level: 1) unequal workforce distribution and 2) lack of inclusive clinical guidelines.

CONCLUSIONS

This rapid review offers a broad range of evidence on the ways AHPs can contribute to the reduction of inequalities in health care, both in terms of access and quality of care and in health outcomes. More research is needed to further understand the impact of AHPs on inequalities affecting specific groups and their contribution to equitable distribution of social determinants of health.

摘要

目标

专职医疗人员在减少健康不平等方面发挥着关键作用。然而,关于他们履行这一职责的方式,缺乏相关证据。本快速综述探讨了专职医疗人员可以在哪些方面减少医疗保健或健康结果方面的不平等;解决健康社会决定因素方面的不平等;并在个人、组织和系统层面支持弱势群体。

研究设计

遵循Cochrane标准进行快速综述并进行叙述性综合分析。

方法

检索了MEDLINE、EMBASE、CINAHL、科学网和AMED,并结合灰色文献,以识别2010年1月至2021年2月期间发表的定量或定性综述文章。

结果

从8727篇参考文献中,有36篇符合纳入标准。使用AMSTAR工具评估了研究的方法学质量,总体较低。由于研究的异质性,无法进行荟萃分析,因此进行了叙述性综合分析。在患者和组织层面出现了三个主题:1)获得专职医疗服务;2)护理质量;3)健康的社会决定因素。在系统层面出现了两个主题:1)劳动力分布不均;2)缺乏包容性临床指南。

结论

本快速综述提供了广泛的证据,说明专职医疗人员可以在哪些方面促进减少医疗保健方面的不平等,包括在获得医疗服务和护理质量以及健康结果方面。需要更多研究来进一步了解专职医疗人员对影响特定群体的不平等的影响,以及他们对健康社会决定因素公平分配的贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3695/9461647/bc358c2fc916/gr1.jpg

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