背景 以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的 对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法 于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果 共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论 农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。
Influencing Factors of Health Management Practices for Older Adults Contracted by Family Doctors in Rural Areas of China:a Scoping Review
Background Health management based on family doctors' contract service is an essential approach for promoting healthy aging for rural older adults in China,yet its implementation is influenced by various factors. Objective To summarize influencing factors of health management for older adults contracted by rural family doctors in China,providing the basis of reference for the accessibility and effectiveness. Methods From January to April 2023,the PRISMA-ScR checklist was used. Studies on health management by family doctor contract service were searched from databases of Web of Science,PubMed,Embase,Medline,CINAHL,CNKI,Wanfang Data,VIP,and CBM from inception to December 2022,and enrolled according to the inclusion and exclusion criteria. Relevant data were extracted,collected,summarized and reported guided by the Social Ecological Model. Results A total of 27 articles were included. We extracted 5 levels of influencing factors related to health management for older adults by family doctors contracted service in rural areas,including individual,interpersonal,organizational,community and policy. Conclusion The implementation of health management for older adults contracted by rural family doctors is influenced by multiple factors. To promote the development of health management for older adults in rural areas,it is necessary to comprehensively consider these influencing factors,clarify the rights and responsibilities of relevant departments and parties,and jointly promote the improvement of the quality and efficiency of health management services based on family doctor contract services.
General practitionersContracted family doctor servicesRural health servicesAgedPopulation health management