Social and policy interventions to reduce hospital admissions among socio-economically disadvantaged groups in OECD countries with universal health care: a systematic review
Author(s)
Type
Journal Article
Abstract
Objectives:
Socioeconomic disadvantage increases the risk of acute illnesses and injuries requiring hospital admission, some of which are avoidable. This systematic review aimed to identify the impact of interventions on hospital admissions in socio-economically disadvantaged populations and identify knowledge gaps.
Design:
Systematic review (PROSPERO CRD42019153666).
Data sources:
We searched MEDLINE (OVID), Embase (OVID), CINAHL (EBSCO),Cochrane CENTRAL (Wiley) and the Web of Knowledge platforms.
Eligibility criteria:
Studies published between January 1 2000 and April 1 2024. We included quantitative studies that included a socio-economically disadvantaged population, conducted in an OECD country with universal health care and reported on hospital admission or readmissions.
Data extraction and synthesis:
We assessed study quality using the Effective Public Health Practice Project (EPHPP) tool. We summarised studies using a narrative synthesis approach and present findings using vote counting as a measure of effect.
Results:
We included 20 studies of interventions targeted towards socioeconomically disadvantaged populations. There impacts on hospitalisations of interventions grouped under three domains – (1) population level health and social policy, (2) health and care services-based interventions, and (3) integrative interventions were mixed. Through vote counting, we found that social policy interventions targeting socio-economically disadvantaged groups, have an important impact on hospitalisations, especially those focused on improved housing and income.
Conclusions:
Whist ongoing efforts to ensure healthcare interventions improve equity of access, experience and outcome are warranted, social policy interventions that address the wider determinants of health such as housing, income and education, are important for controlling rates of hospital admissions in socioeconomically disadvantaged groups. This underscores the value of multi-sectoral action to reduce inequalities. Future studies should explore the long-term outcomes of interventions, particularly integrative ones, which may bring benefits in the long-term but not so much in the short term.
Socioeconomic disadvantage increases the risk of acute illnesses and injuries requiring hospital admission, some of which are avoidable. This systematic review aimed to identify the impact of interventions on hospital admissions in socio-economically disadvantaged populations and identify knowledge gaps.
Design:
Systematic review (PROSPERO CRD42019153666).
Data sources:
We searched MEDLINE (OVID), Embase (OVID), CINAHL (EBSCO),Cochrane CENTRAL (Wiley) and the Web of Knowledge platforms.
Eligibility criteria:
Studies published between January 1 2000 and April 1 2024. We included quantitative studies that included a socio-economically disadvantaged population, conducted in an OECD country with universal health care and reported on hospital admission or readmissions.
Data extraction and synthesis:
We assessed study quality using the Effective Public Health Practice Project (EPHPP) tool. We summarised studies using a narrative synthesis approach and present findings using vote counting as a measure of effect.
Results:
We included 20 studies of interventions targeted towards socioeconomically disadvantaged populations. There impacts on hospitalisations of interventions grouped under three domains – (1) population level health and social policy, (2) health and care services-based interventions, and (3) integrative interventions were mixed. Through vote counting, we found that social policy interventions targeting socio-economically disadvantaged groups, have an important impact on hospitalisations, especially those focused on improved housing and income.
Conclusions:
Whist ongoing efforts to ensure healthcare interventions improve equity of access, experience and outcome are warranted, social policy interventions that address the wider determinants of health such as housing, income and education, are important for controlling rates of hospital admissions in socioeconomically disadvantaged groups. This underscores the value of multi-sectoral action to reduce inequalities. Future studies should explore the long-term outcomes of interventions, particularly integrative ones, which may bring benefits in the long-term but not so much in the short term.
Date Acceptance
2025-09-01
Citation
BMJ Public Health
ISSN
2753-4294
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Public Health
Copyright Statement
Subject to copyright. This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
Publication Status
Accepted