McArthur Megan, Tian Persephone, Kho Kimberly A, Bhavan Kavita P, Balasubramanian Bijal A, Ganguly Anisha P
University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Division of Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Front Public Health. 2024 Dec 3;12:1443992. doi: 10.3389/fpubh.2024.1443992. eCollection 2024.
As health systems strive to screen for and address social determinants of health (SDOH), the role of access to childcare and barriers to healthcare posed by childcare needs remains underexplored. A gap exists in synthesizing existing evidence on the role of access to childcare as a SDOH.
This scoping review aimed to examine and analyze existing literature on the role of childcare needs as a social determinant of access to healthcare. We conducted a structured literature search across PubMed, Scopus, health policy fora, and professional healthcare societies to inclusively aggregate studies across interdisciplinary sources published between January 2000 and June 2023. Two independent reviewers reviewed results to determine inclusions and exclusions. Studies were coded into salient themes utilizing an iterative inductive approach.
Among 535 search results, 526 met criteria for eligibility screening. Among 526 eligible studies, 91 studies met inclusion criteria for analysis. Five key themes were identified through data analysis: (1) barriers posed by childcare needs to healthcare appointments, (2) the opportunity for alternative care delivery models to overcome childcare barriers, (3) the effect of childcare needs on participation in medical research, (4) the impact of the COVID-19 pandemic on childcare needs, and (5) the disproportionate burden of childcare experienced by vulnerable populations.
Childcare needs remain underexplored in existing research. Current evidence demonstrates the relevance of childcare needs as a barrier to healthcare access, however dedicated studies are lacking. Future research is needed to understand mechanisms of childcare barriers in access to healthcare and explore potential interventions.
随着卫生系统努力筛查和解决健康的社会决定因素（SDOH），获得儿童保育服务的作用以及儿童保育需求对医疗保健造成的障碍仍未得到充分探索。在综合现有关于获得儿童保育服务作为一种健康的社会决定因素的证据方面存在差距。
本范围综述旨在检查和分析现有文献，以探讨儿童保育需求作为获得医疗保健服务的社会决定因素的作用。我们在PubMed、Scopus、卫生政策论坛和专业医疗协会中进行了结构化文献检索，以全面汇总2000年1月至2023年6月期间跨学科来源发表的研究。两名独立评审员对结果进行评审以确定纳入和排除标准。采用迭代归纳法将研究编码为突出主题。
在535条检索结果中，526条符合资格筛查标准。在526项符合条件的研究中，91项研究符合分析纳入标准。通过数据分析确定了五个关键主题：（1）儿童保育需求对医疗预约造成的障碍；（2）替代护理模式克服儿童保育障碍的机会；（3）儿童保育需求对参与医学研究的影响；（4）新冠疫情对儿童保育需求的影响；（5）弱势群体在儿童保育方面承受的不成比例负担。
儿童保育需求在现有研究中仍未得到充分探索。目前的证据表明儿童保育需求与获得医疗保健服务的障碍相关，但缺乏专门的研究。未来需要开展研究以了解儿童保育障碍在获得医疗保健服务方面的机制，并探索潜在的干预措施。
