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提高初级保健向专科服务的转诊:澳大利亚背景下的一项为期 10 年的全球系统评价方案。

Improving primary care referral to specialist services: a protocol for a 10-year global systematic review in the Australian context.

机构信息

School of Nursing and Midwifery, University of Southern Queensland, Darling Heights, Queensland, Australia

Population Health, Cancer and Chronic Disease Group QIMR-Berghofer Medical Research Institute, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

出版信息

BMJ Open. 2023 Aug 29;13(8):e068927. doi: 10.1136/bmjopen-2022-068927.

Abstract

INTRODUCTION

Barriers to accessing specialist services impart a significant burden on patient outcomes and experience as well as a cost and administrative burden on health systems due to healthcare wastage and inefficiencies. This paper outlines the planned protocol for a systematic review relating to how health systems perform with regard to patient access to specialist care, and the efficacy of interventions aimed at improving this.

METHODS AND ANALYSIS

Systematic review of the literature will be carried out on publications retrieved by searching the following electronic literature databases: EBSCOhost Megafile Ultimate (Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Ultimate, APA Psychological Abstracts (PsycINFO), HealthSource), PubMed (Medical Literature Analysis and Retrieval System Online (MEDLINE)), Elsevier Bibliographic Database (Scopus), Excerpta Medica Database (EMBASE), Web of Science and The Cochrane Library. Articles published over a 10-year period (2012-2022) will be analysed to determine; current accessibility and availability problems faced by primary care services when referring patients to specialist care, and the effectiveness of interventions to improve primary care access to specialist services. Grey literature publications (ie, government reports, policy statements and issues papers, conference proceedings) will not be analysed in this review. Articles not published in English, Spanish or Portuguese will not be included. Two independent reviewers will conduct the initial screening, disagreements will be resolved by a third independent reviewer, following which data extraction and selection of eligible sources will be carried out. Selected articles will be categorised on study design, setting and participants. Methodological quality and heterogeneity will subsequently be assessed using the Mixed Methods Appraisal Tool. A descriptive approach will be used to review and synthesise the findings.

ETHICS AND DISSEMINATION

This study does not require ethics committee review as it solely focuses on analysing published literature. Findings will be published and disseminated through a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42022354890.

摘要

简介

由于医疗浪费和效率低下,获取专科服务的障碍给患者的治疗效果和体验带来了重大负担,同时也给卫生系统带来了成本和管理负担。本文概述了一项系统评价的计划方案,该方案旨在研究卫生系统在患者获得专科护理方面的表现,以及旨在改善这方面的干预措施的效果。

方法和分析

将对从以下电子文献数据库中检索到的文献进行系统综述:EBSCOhost Megafile Ultimate(综合护理和联合健康文献索引(CINAHL)、学术搜索终极版、APA 心理文摘(PsycINFO)、健康源)、PubMed(医学文献分析和检索系统在线(MEDLINE))、爱思唯尔书目数据库(Scopus)、摘录医学数据库(EMBASE)、Web of Science 和 The Cochrane Library。将分析在过去 10 年(2012-2022 年)发表的文章,以确定初级保健服务在向专科护理转诊患者时面临的当前可及性和可用性问题,以及改善初级保健获得专科服务的干预措施的效果。本综述将不分析灰色文献出版物(即政府报告、政策声明和问题文件、会议记录)。未以英文、西班牙文或葡萄牙文发表的文章将不包括在内。两名独立评审员将进行初步筛选,意见分歧将由第三名独立评审员解决,然后将进行数据提取和合格来源的选择。选定的文章将根据研究设计、设置和参与者进行分类。随后将使用混合方法评估工具评估方法学质量和异质性。将采用描述性方法审查和综合研究结果。

伦理和传播

本研究不需要伦理委员会审查,因为它仅侧重于分析已发表的文献。研究结果将通过同行评议的期刊发表和传播。

PROSPERO 注册号:CRD42022354890。

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