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气候相关风险和极端事件对农村和偏远地区初级保健的健康结果和卫生利用的影响:范围综述。

Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review.

机构信息

Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.

Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia.

出版信息

Fam Pract. 2023 May 31;40(3):486-497. doi: 10.1093/fampra/cmac151.

Abstract

BACKGROUND

Rural populations are at risk of climate-related impacts due to ecological and geographical determinants, potentially leading to greater morbidity and health utilization. They are often highly dependent on primary care services. However, no rural- or primary care specific synthesis of these issues has ever been conducted. This review aimed to identify, characterize, and summarize existing research on the effects of climate-related events on utilization and health outcomes of primary care in rural and remote areas and identify related adaptation strategies used in primary care to climate-related events.

METHODS

A scoping review following PRISMA-ScR guidelines was conducted, examining peer-reviewed English-language articles published up to 31 October 2022. Eligible papers were empirical studies conducted in primary care settings that involved climate-related events as exposures, and health outcomes or utilization as study outcomes. Two reviewers independently screened and extracted relevant information from selected papers. Data were analysed using content analysis and presented using a narrative approach.

RESULTS

We screened 693 non-duplicate papers, of those, 60 papers were analysed. Climate-related events were categorized by type, with outcomes described in terms of primary, secondary, and tertiary effects. Disruption of primary care often resulted from shortages in health resources. Primary care may be ill-prepared for climate-related events but has an important role in supporting the development of community.

CONCLUSIONS

Findings suggest various effects of climate-related events on primary care utilization and health outcomes in rural and remote areas. There is a need to prepare rural and remote primary care service before and after climate-related events.

摘要

背景

由于生态和地理决定因素,农村人口面临与气候相关的影响的风险,这可能导致更高的发病率和卫生利用。他们通常高度依赖初级保健服务。然而,以前从未对这些问题进行过农村或初级保健的专门综合研究。本综述旨在确定、描述和总结现有关于与气候相关的事件对农村和偏远地区初级保健的利用和健康结果的影响的研究,并确定在初级保健中针对与气候相关的事件使用的相关适应策略。

方法

按照 PRISMA-ScR 指南进行了范围综述,审查了截至 2022 年 10 月 31 日发表的同行评议的英文文章。合格的论文是在初级保健环境中进行的实证研究,涉及气候相关事件作为暴露因素,以及健康结果或利用作为研究结果。两名审查员独立筛选并从选定的论文中提取相关信息。使用内容分析对数据进行分析,并采用叙述方法呈现。

结果

我们筛选了 693 篇非重复论文,其中 60 篇论文进行了分析。气候相关事件按类型分类,结果根据初级、次级和三级效应来描述。初级保健的中断通常是由于卫生资源短缺造成的。初级保健可能对与气候相关的事件准备不足,但在支持社区发展方面具有重要作用。

结论

研究结果表明,与气候相关的事件对农村和偏远地区初级保健利用和健康结果有各种影响。在与气候相关的事件前后,需要为农村和偏远地区的初级保健服务做好准备。

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