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Trace and evaluation systems for health services quality in rural and remote areas: a systematic review
Authors:Xiuxia Li  Lili Wei  Wenru Shang  Xin Xing  Min Yin  Juan Ling  Kuoray Mao  Yiliang Zhu  Kehu Yang
Affiliation:1.School of Public Health,Lanzhou University,Lanzhou,China;2.Evidence-Based Medicine Center, School of Basic Medical Sciences,Lanzhou University,Lanzhou,China;3.Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province,Lanzhou,China;4.Department of Sociology,Colorado State University,Fort Collins,USA;5.College of Medicine,University of New Mexico,Albuquerque,USA
Abstract:

Aim

To provide a systematic review of the existing theory, framework, systems and instruments for tracing and evaluating quality in rural health services.

Subjects and methods

We searched six electronic databases up to March 2016. Observational studies of quality assessment of rural health services using theoretical models were included. Ekman’s scale was used to evaluate the quality of the included studies.

Results

A total of 18 studies, published between 2001 and 2015, met the inclusion criteria. The corresponding authors for most of them (7, 44%) are from Chinese institutions and three (3, 17%) from Australian institutions. Five studies (28%) focused on township hospitals. Primary health care quality was reported in five studies (28%), followed by clinical service in four (22%). More than half of the studies (61%) were considered of high quality, and the remainder was of moderate quality. These studies applied 16 theoretical systems, including the model/pattern (4, 25%), method/tool (7, 44%) and framework of the theory (5, 31%). Most of the theoretical models (14, 88%) obtained positive observations. In addition, the conceptual model (6, 36%) and TOPSIS method (2, 13%) were more frequently reported.

Conclusion

Although most of the current studies were considered to have high-quality and positive results, there were limitations in the number of publications and research on theoretical systems. The lacks of unified standards and comprehensive evaluation are important issues that need to be pointed out and resolved.
Keywords:
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