维持流动医疗队以实现医疗保健的公平性:PLS-SEM 方法。

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-09-02 DOI:10.1186/s12939-024-02260-x
Jignesh Patel, Sangita More, Pravin Sohani, Shrinath Bedarkar, Kamala Kannan Dinesh, Deepika Sharma, Sanjay Dhir, Sushil Sushil, Gunjan Taneja, Raj Shankar Ghosh
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引用次数: 0

摘要

背景:让农村、部落和弱势群体公平获得医疗保健服务一直是全球研究人员、学者和政策制定者关注的新领域。改善医疗保健的公平获取需要创新的干预措施。这就要求明确需要加强服务创新的哪种运作模式,以实现转型变革,并使公共卫生干预措施具有可持续性。本研究旨在确定流动医疗单位(MMUs)运作模式的组成部分,以此作为提供公平医疗服务的创新干预措施:本研究通过实证研究探讨了可扩展性、可负担性、可复制性(SAR)和免疫效果对流动医疗单位可持续性的影响,从而为未来的初级医疗保健制定一个框架。数据是通过一项调查收集的,来自印度六个邦的 207 名医疗保健专业人员回答了调查问卷。采用偏最小二乘法结构方程模型(PLS-SEM)来实证确定各种结构之间的相互关系:标准化路径系数显示,作为自变量的三个因素(SAR)对免疫接种绩效有显著影响。比较三个假设关系表明,可复制性的影响最大,其次是可扩展性和可负担性。研究发现,免疫接种绩效对可持续性有重大直接影响。为评估可持续性,多指标类集单位是可持续医疗保健系统和全民医保的重要组成部分和推动因素:本研究为政策制定者和公共卫生专业人员提供了多学科医疗单位运作模式的关键组成部分,从而实现可持续发展。研究框架为研究可扩展性、可负担性和可复制性对作为主要公共医疗成果的免疫接种覆盖率的影响提供了可靠的依据。
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Sustaining the mobile medical units to bring equity in healthcare: a PLS-SEM approach.

Background: Equitable access to healthcare for rural, tribal, and underprivileged people has been an emerging area of interest for researchers, academicians, and policymakers worldwide. Improving equitable access to healthcare requires innovative interventions. This calls for clarifying which operational model of a service innovation needs to be strengthened to achieve transformative change and bring sustainability to public health interventions. The current study aimed to identify the components of an operational model of mobile medical units (MMUs) as an innovative intervention to provide equitable access to healthcare.

Methods: The study empirically examined the impact of scalability, affordability, replicability (SAR), and immunization performance on the sustainability of MMUs to develop a framework for primary healthcare in the future. Data were collected via a survey answered by 207 healthcare professionals from six states in India. Partial least squares structural equation modeling (PLS-SEM) was conducted to empirically determine the interrelationships among various constructs.

Results: The standardized path coefficients revealed that three factors (SAR) significantly influenced immunization performance as independent variables. Comparing the three hypothesized relationships demonstrates that replicability has the most substantial impact, followed by scalability and affordability. Immunization performance was found to have a significant direct effect on sustainability. For evaluating sustainability, MMUs constitute an essential component and an enabler of a sustainable healthcare system and universal health coverage.

Conclusion: This study equips policymakers and public health professionals with the critical components of the MMU operational model leading toward sustainability. The research framework provides reliable grounds for examining the impact of scalability, affordability, and replicability on immunization coverage as the primary public healthcare outcome.

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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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