Current Status and Implications of Ecology of Medical Care Model in Health Services Research: a Scoping Review

Abstract

Background In the last decade, the application value of the ecology of medical care model has become prominent and received great attention from scholars. Differences and changes in the theoretical modeling constructs of the ecology of medical care model can reflect the transformation of the health care model to a certain extent, and provide an evidence base for understanding the health needs of population and the utilization of health services in China. Objective To integrate and compare researches using the ecology of medical care model, describe the current status of research using the ecology of medical care model, compare research methods and key findings. Methods In June 2022, PubMed, Ovid Medline, Web of Science, EmBase, China Biomedical Literature Service System, CNKI, and Wanfang were searched according to the keywords without limiting the language, from 1961 to 2022. Literature was screened, information was extracted and descriptive analysis was performed under the guidance of the Joanna Briggs Institute (JBI) methodology manual for scoping review. Results A total of 28 articles from the eligible literature were included, of which 22 (78.6%) were published after 2010. Most of the studies used the ecology of medical care model to focus on the health needs of the population, healthcare resource utilization patterns and healthcare-seeking behavior, and disease referrals. In terms of study population, most of the studies covered all-age populations (11 articles, 39.3%), and 7 studies (25.0%) were conducted on specific populations. Four studies were conducted in China, all in urban areas. Less attention was paid to self-seeking of help in patients (over-the-counter medicines, massages, etc.) in studies of developing countries (regions) compared to developed countries (regions), and available ecological models reflected lower rates of patient self-reporting of health problems (symptoms), but higher rates of hospital outpatient and emergency room visits in developing countries (regions) . Conclusion The ecology of medical care model and its research methods have evolved over the past two decades, remaining a valuable tool to help researchers and policy makers understand the demand for health care and the relationship between the supply and demand of health care resources. Currently, the application of the ecology of medical care is limited in China, but future studies are needed to apply this tool to reflect the health inequity and unmet health needs in China, carry out research in the field of population medicine, to provide evidence for improving the rational allocation of health resources in Chinese population.

Keywords

• ecology of medical care model|health services needs and demand|resource allocation|health inequities|population medicine|scoping review