背景:数字服务可以成为治疗非传染性疾病的有效和具有成本效益的选择,但由于治疗效果不均匀,其普适性有限。这篇综述旨在评估数字服务对人口健康的影响,成本,以及患者和医疗保健专业人员的满意度,并确定在医疗保健和社会福利中使用数字服务的促进者和障碍。
方法:本研究方案于2022年9月4日注册到国际前瞻性系统审查登记册,PROSPERO(CRD420223555635)。审查是利用审查和传播中心进行的,科克伦,OvidMedline,Scopus,和WebofScience在2022年6月。对纳入的审评的方法学质量进行了评估。数字服务的影响被归类为没有证据,没有优势,以及混合和积极的影响。归纳内容分析用于识别促进者和障碍。
结果:本综述共纳入66项研究,其中64%被评价为高质量。尚未确定有关数字服务对社会福利影响的研究。65%的评论评估了数字服务对人口健康的影响,具有混合效应;21%的成本具有混合效应;27%的患者对积极效应的满意度;7.6%的医疗保健专业人员对混合效应的满意度。各种功能,分配,最终用户支持,有组织的服务,和服务发展促进了数字服务的使用。相应地,障碍与服务限制有关,数字能力,资金和服务策略,资源和变更管理。
结论:与常规护理相比,数字服务对人群健康和成本的影响喜忧参半,患者满意度高.混合医疗保健专业人员的满意度与数字服务的使用有关,研究较少。为了确保数字服务的成功实施和可持续性,必须注意解决各级障碍和支持促进者。
BACKGROUND: Digital services can be effective and cost-efficient options for treating non-communicable diseases, but generalizability is limited due to heterogeneous treatment effects. This umbrella
review aims to evaluate the impact of digital services on population health, costs, and patient and healthcare professional satisfaction, and to identify facilitators and barriers to using digital services in healthcare and social welfare.
METHODS: The protocol of the study was registered on the 4th of September 2022 to the International Prospective Register of Systematic Reviews, PROSPERO (CRD42022355635). The
review was performed using the Centre for Reviews and Dissemination, Cochrane, Ovid Medline, Scopus, and Web of Science in June 2022. The methodological quality of the included reviews was assessed. The impact of digital services was categorized as no evidence, no dominance, and mixed and positive effect. Inductive content analysis was used to identify facilitators and barriers.
RESULTS: A total of 66 studies were included in the
review, 64 % of which were evaluated as high quality. Studies on the impact of digital services in social welfare were not identified. Sixty-five percent of reviews evaluated the impact of digital services on population health with mixed effects; 21 % were on costs with mixed effects; 27 % were on patient satisfaction with positive effects; and 7.6 % were on healthcare professionals\' satisfaction with mixed effects. Various features, allocation, end-user support, organized services, and service development facilitated the use of digital services. Correspondingly, barriers were related to service limitations, digital competency, funding- and service strategies, resources and change management.
CONCLUSIONS: Compared to usual care, digital services had a mixed impact on population health and costs with high satisfaction in patients. Mixed healthcare professionals\' satisfaction was associated with the use of digital services, and it was less studied. To ensure successful implementation and sustainability of digital services, attention must be paid to address barriers and supporting facilitators at all levels.