Hoyos-Loya Elizabeth, González-Robledo María Cecilia, Gutiérrez Juan Pablo
Escuela de Salud Pública de México, Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
Aten Primaria. 2024 Nov;56(11):103051. doi: 10.1016/j.aprim.2024.103051. Epub 2024 Jul 22.
To identify the structural and intermediate determinants associated with avoidable hospitalizations (AH) of patients with type2 diabetes mellitus (T2DM).
Literature review based on narrative synthesis.
Databases: PubMed, Science Direct, and Latin American and Caribbean Literature in Health Sciences (LILACS).
Documents were selected and analyzed under a critical literature review, considering inclusion and exclusion criteria.
Information extracted from each selected article was synthesized based on the countries' income levels and the social determinants of health framework.
A total of 4,166 articles were relevant, 36 were selected for review. From this selection, 21 were publications conducted in high-income countries, 14 in upper-middle-income countries, and one in lower-middle-income countries. The review identified that the coverage of health services -mainly primary health care- and health insurance contribute to reducing the risk of AH for T2DM, while social inequalities tend to increase the risk.
The AH due to T2DM are susceptible to reduction through policies that contribute to increasing effective access to health services (availability, insurance), since they express social inequality, occurring to a greater extent in socioeconomically vulnerable populations. This review also provides evidence of the need to expand research on this topic in middle and low-income countries.
确定与2型糖尿病(T2DM)患者可避免住院(AH)相关的结构和中间决定因素。
基于叙述性综合的文献综述。
数据库:PubMed、科学Direct和拉丁美洲及加勒比地区健康科学文献数据库(LILACS)。
在严格的文献综述下,根据纳入和排除标准选择并分析文献。
从每篇选定文章中提取的信息根据国家收入水平和健康社会决定因素框架进行综合。
共有4166篇文章相关,36篇被选中进行综述。在这些选中的文章中,21篇来自高收入国家,14篇来自中高收入国家,1篇来自中低收入国家。综述发现,卫生服务(主要是初级卫生保健)的覆盖范围和医疗保险有助于降低T2DM患者AH的风险,而社会不平等往往会增加这种风险。
由于T2DM导致的AH可通过有助于增加有效获得卫生服务(可及性、保险)的政策来降低,因为它们体现了社会不平等,在社会经济弱势群体中更为普遍。本综述还提供了证据,表明有必要在中低收入国家扩大对该主题的研究。