医疗保健生态学模型在卫生服务研究中的应用现状及启示:一项概况性评价
R197; 背景 近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注.医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务利用情况提供证据基础.目的 对运用医疗保健生态学模型的研究进行整合和对比,以描述使用医疗保健生态学模型建立的研究现状、对比研究方法和主要发现.方法 于 2022 年 6 月,在PubMed、Ovid Medline、Web of Science、EmBase、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中根据关键词、不限制...
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| Published in | 中国全科医学 Vol. 27; no. 4; pp. 391 - 399 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
100005 北京市,中国医学科学院/北京协和医学院群医学及公共卫生学院
05.02.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1007-9572 |
| DOI | 10.12114/j.issn.1007-9572.2022.0895 |
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| Abstract | R197; 背景 近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注.医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务利用情况提供证据基础.目的 对运用医疗保健生态学模型的研究进行整合和对比,以描述使用医疗保健生态学模型建立的研究现状、对比研究方法和主要发现.方法 于 2022 年 6 月,在PubMed、Ovid Medline、Web of Science、EmBase、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中根据关键词、不限制语种开展检索,检索时限为 1961-2022 年.在Joanna Briggs Institute(JBI)概况性评价方法学手册的指导下,对文献进行筛选、信息提取,并开展描述性分析.结果 共纳入符合要求的文献 28 篇,其中 22 篇(78.6%)发表于2010 年以后.多数研究运用医疗保健生态学模型重点关注人群的健康需求、医疗资源利用模式,聚焦就医行为模式、疾病转诊等问题.在研究人群方面,多数研究覆盖全年龄段人群(11 篇,39.3%),针对特定人群开展的研究有 7 篇(25.0%).有 4 项研究在中国开展,均针对城市地区.相较于发达国家(地区),发展中国家(地区)研究中较少关注患者自我寻求帮助(非处方药、按摩等)情况,已有的医疗保健生态学模型反映出发展中国家(地区)具有较低的患者自报有健康问题(症状)比例,但具有更高的医院门诊就诊和急诊就诊比例.结论 医疗保健生态学模型及其研究方法在过去20年间不断演进,仍然是帮助研究者和政策制定者了解医疗保健需求和医疗资源供需关系的重要工具.目前,中国对医疗保健生态学框架的应用程度不高,未来可更多地运用该模型反映卫生服务不平等和健康需求未被满足情况,并可开展群医学等领域的研究,为提高我国人群健康资源合理分配提供证据基础. |
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| AbstractList | R197; 背景 近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注.医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务利用情况提供证据基础.目的 对运用医疗保健生态学模型的研究进行整合和对比,以描述使用医疗保健生态学模型建立的研究现状、对比研究方法和主要发现.方法 于 2022 年 6 月,在PubMed、Ovid Medline、Web of Science、EmBase、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中根据关键词、不限制语种开展检索,检索时限为 1961-2022 年.在Joanna Briggs Institute(JBI)概况性评价方法学手册的指导下,对文献进行筛选、信息提取,并开展描述性分析.结果 共纳入符合要求的文献 28 篇,其中 22 篇(78.6%)发表于2010 年以后.多数研究运用医疗保健生态学模型重点关注人群的健康需求、医疗资源利用模式,聚焦就医行为模式、疾病转诊等问题.在研究人群方面,多数研究覆盖全年龄段人群(11 篇,39.3%),针对特定人群开展的研究有 7 篇(25.0%).有 4 项研究在中国开展,均针对城市地区.相较于发达国家(地区),发展中国家(地区)研究中较少关注患者自我寻求帮助(非处方药、按摩等)情况,已有的医疗保健生态学模型反映出发展中国家(地区)具有较低的患者自报有健康问题(症状)比例,但具有更高的医院门诊就诊和急诊就诊比例.结论 医疗保健生态学模型及其研究方法在过去20年间不断演进,仍然是帮助研究者和政策制定者了解医疗保健需求和医疗资源供需关系的重要工具.目前,中国对医疗保健生态学框架的应用程度不高,未来可更多地运用该模型反映卫生服务不平等和健康需求未被满足情况,并可开展群医学等领域的研究,为提高我国人群健康资源合理分配提供证据基础. |
| Abstract_FL | Background In the last decade,the application value of the ecology of medical care model has become prominent and received great attention from scholars.Differences and changes in the theoretical modeling constructs of the ecology of medical care model can reflect the transformation of the health care model to a certain extent,and provide an evidence base for understanding the health needs of population and the utilization of health services in China.Objective To integrate and compare researches using the ecology of medical care model,describe the current status of research using the ecology of medical care model,compare research methods and key findings.Methods In June 2022,PubMed,Ovid Medline,Web of Science,EmBase,China Biomedical Literature Service System,CNKI,and Wanfang were searched according to the keywords without limiting the language,from 1961 to 2022.Literature was screened,information was extracted and descriptive analysis was performed under the guidance of the Joanna Briggs Institute(JBI)methodology manual for scoping review.Results A total of 28 articles from the eligible literature were included,of which 22(78.6%)were published after 2010.Most of the studies used the ecology of medical care model to focus on the health needs of the population,healthcare resource utilization patterns and healthcare-seeking behavior,and disease referrals.In terms of study population,most of the studies covered all-age populations(11 articles,39.3%),and 7 studies(25.0%)were conducted on specific populations.Four studies were conducted in China,all in urban areas.Less attention was paid to self-seeking of help in patients(over-the-counter medicines,massages,etc.)in studies of developing countries(regions)compared to developed countries(regions),and available ecological models reflected lower rates of patient self-reporting of health problems(symptoms),but higher rates of hospital outpatient and emergency room visits in developing countries(regions).Conclusion The ecology of medical care model and its research methods have evolved over the past two decades,remaining a valuable tool to help researchers and policy makers understand the demand for health care and the relationship between the supply and demand of health care resources.Currently,the application of the ecology of medical care is limited in China,but future studies are needed to apply this tool to reflect the health inequity and unmet health needs in China,carry out research in the field of population medicine,to provide evidence for improving the rational allocation of health resources in Chinese population. |
| Author | 张伋 张峥岩 邵瑞太 王振中 宫恩莹 |
| AuthorAffiliation | 100005 北京市,中国医学科学院/北京协和医学院群医学及公共卫生学院 |
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| Author_FL | GONG Enying ZHANG Zhengyan ZHANG Ji SHAO Ruitai WANG Zhenzhong |
| Author_FL_xml | – sequence: 1 fullname: ZHANG Zhengyan – sequence: 2 fullname: WANG Zhenzhong – sequence: 3 fullname: ZHANG Ji – sequence: 4 fullname: GONG Enying – sequence: 5 fullname: SHAO Ruitai |
| Author_xml | – sequence: 1 fullname: 张峥岩 – sequence: 2 fullname: 王振中 – sequence: 3 fullname: 张伋 – sequence: 4 fullname: 宫恩莹 – sequence: 5 fullname: 邵瑞太 |
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| Keywords | Health services needs and demand 资源配置 群医学 Health inequities 健康不平等 Resource allocation Scoping review Population medicine 医疗保健生态学模型 概况性评价 Ecology of medical care model 卫生服务需求 |
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| Title | 医疗保健生态学模型在卫生服务研究中的应用现状及启示:一项概况性评价 |
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