目的: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。
方法:基于叙事综合的文献综述。
方法:数据库:PubMed,科学直接,以及拉丁美洲和加勒比健康科学文献(LILACS)。
方法:在批判性文献综述下选择和分析文件,考虑纳入和排除标准。
方法:从每个选定的文章中提取的信息是根据国家/地区的收入水平和健康框架的社会决定因素进行综合的。
结果:共有4,166篇相关文章,选择36人进行审查。从这个选择,21是在高收入国家发表的出版物,14在中高收入国家,和一个在中低收入国家。审查发现,卫生服务-主要是初级卫生保健-和健康保险的覆盖范围有助于降低T2DM的AH风险。而社会不平等往往会增加风险。
结论:由于T2DM导致的AH很容易通过有助于增加有效获得卫生服务的政策来减少(可用性,insurance),因为他们表达了社会不平等,在更大程度上发生在社会经济弱势群体中。这篇综述还提供了证据,证明有必要在中低收入国家扩大对这一主题的研究。
OBJECTIVE: To identify the structural and intermediate determinants associated with avoidable hospitalizations (AH) of patients with type2 diabetes mellitus (T2DM).
METHODS: Literature
review based on narrative synthesis.
METHODS: Databases: PubMed, Science Direct, and Latin American and Caribbean Literature in Health Sciences (LILACS).
METHODS: Documents were selected and analyzed under a critical literature
review, considering inclusion and exclusion criteria.
METHODS: Information extracted from each selected article was synthesized based on the countries\' income levels and the social determinants of health framework.
RESULTS: 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.
CONCLUSIONS: 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.