NIVEL, Netherlands Institute for Health Services Research, Utrecht University, Netherlands.
J Health Serv Res Policy. 2011 Jul;16 Suppl 2:16-26. doi: 10.1258/jhsrp.2011.011040.
To provide an overview of the principal areas of research on health care organization and service delivery and to identify priority areas from a European comparative perspective. Given the large quantity of articles produced on health care organizations, we focus on primary care and hospital care.
A combination of methods was used for describing past and current research: (i) bibliometric analyses of published research in Pubmed and Embase 2000-09; (ii) a further classification of research based on a sample of 1,010 articles; and (iii) an identification of relevant EU-funded projects over the period 2000-10. An online survey of experts was carried out to identify priorities. The results were refined through conference discussions.
Research into health care organizations varies considerably across Europe. This is only partly associated with differences in countries' gross domestic product or population. Studies were categorized into four main domains: intra-organizational control; inter-organizational relations; patient relations; and governance and accountability. Past and current research may not reflect future priorities as the domain of 'inter-organizational relations' is regarded by most experts as the top priority for the future, while the smallest share in the sample of published research and EU-funded projects fell into that category. Expert views show considerable homogeneity, regardless of their role in the health care system or their country. Specific future priorities include the integration of care across organizational boundaries (including the relationship between primary and secondary care), patient involvement and participation and workforce skill-mix.
The research priorities identified in this study relate to important shared challenges in Europe's health care systems. This makes cross-border learning important, especially given the clear geographical variation in health services research (HSR) funding and capacity in Europe.
从欧洲比较的角度，提供医疗保健组织和服务提供的主要研究领域的概述，并确定优先领域。鉴于大量的医疗保健组织文章，我们专注于初级保健和医院护理。
采用了多种方法来描述过去和现在的研究：（i）对 2000-09 年 Pubmed 和 Embase 中发表的研究进行文献计量分析; （ii）根据 1010 篇文章的样本进一步分类研究; （iii）确定 2000-10 年期间相关的欧盟资助项目。对专家进行了在线调查，以确定优先事项。通过会议讨论对结果进行了改进。
在整个欧洲，医疗保健组织的研究差异很大。这与各国国内生产总值或人口的差异只有部分相关。研究分为四个主要领域：组织内控制; 组织间关系; 医患关系; 以及治理和问责制。过去和现在的研究可能无法反映未来的优先事项，因为大多数专家认为“组织间关系”领域是未来的首要任务，而在已发表的研究和欧盟资助项目样本中所占比例最小。专家的观点表现出相当大的同质性，无论他们在医疗保健系统中的角色或他们的国家如何。未来的具体优先事项包括跨越组织边界的护理整合（包括初级保健和二级保健之间的关系）、患者参与和参与以及劳动力技能组合。
本研究确定的研究优先事项与欧洲医疗保健系统中的重要共同挑战有关。这使得跨境学习变得很重要，特别是考虑到欧洲卫生服务研究（HSR）资金和能力的明显地域差异。
