Sevastidis Abraham, Wanni Arachchige Dona Sithara, Gold Lisa, Sciberra Emma, Coghill David, Le Ha Nguyet Dao
Deakin Health Economics School of Health and Social Development Faculty of Health Deakin University Burwood Victoria Australia.
Murdoch Children's Research Institute Royal Children's Hospital Burwood Victoria Australia.
JCPP Adv. 2023 May 25;3(3):e12170. doi: 10.1002/jcv2.12170. eCollection 2023 Sep.
ADHD (attention-deficit/hyperactivity disorder) affects 5% of children on average. Despite the high need to access services for ADHD treatment, not all children with ADHD utilise healthcare services equally. This study aims to systematically synthesise evidence of equity and equality in health service use/costs and health-related quality of life (HRQoL)/wellbeing of children with ADHD across socioeconomic (SES) classes.
The literature search was conducted across seven databases (Academic Search complete, MEDLINE Complete, PsycINFO, ERIC, Global Health, CINAHL and EconLit). The search was limited to peer-reviewed articles published to 23 January 2023 in English and focused on children. Study quality was assessed using the Critical Appraisal Skills Program (CASP), Joanna Briggs Institute (JBI) and Mixed Methods Appraisal Tool (MMAT) checklists.
25 out of 1207 articles were eligible for inclusion. The results showed that SES was associated with different types of healthcare utilisation. Only three studies were found on HRQoL/well-being. Children with ADHD from low SES families had lower HRQoL than children from high SES families.
This study found that a social gradient exists in both healthcare service use and children's HRQoL among those with ADHD.
注意缺陷多动障碍（ADHD）平均影响5%的儿童。尽管对ADHD治疗服务的需求很高，但并非所有患有ADHD的儿童都能平等地利用医疗服务。本研究旨在系统地综合不同社会经济阶层（SES）中ADHD儿童在医疗服务使用/成本、健康相关生活质量（HRQoL）/幸福感方面的公平和平等证据。
在七个数据库（学术搜索完整版、MEDLINE完整版、PsycINFO、教育资源信息中心、全球健康、护理学与健康领域数据库和经济文献数据库）中进行文献检索。检索限于2023年1月23日前发表的英文同行评审文章，且聚焦于儿童。使用批判性评估技能计划（CASP）、乔安娜·布里格斯研究所（JBI）和混合方法评估工具（MMAT）清单评估研究质量。
1207篇文章中有25篇符合纳入标准。结果表明，社会经济地位与不同类型的医疗服务利用相关。仅发现三项关于健康相关生活质量/幸福感的研究。来自低社会经济地位家庭的ADHD儿童的健康相关生活质量低于来自高社会经济地位家庭的儿童。
本研究发现，ADHD患者在医疗服务使用和儿童健康相关生活质量方面均存在社会梯度。
