Malmivaara Antti
a Centre for Health and Social Economics , National Institute for Health and Welfare , Helsinki , Finland.
Ann Med. 2016;48(4):211-5. doi: 10.3109/07853890.2016.1155228. Epub 2016 Mar 15.
Interventions directed to system features of public health and health care should increase health and welfare of patients and population.
To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs).
The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs.
The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality.
System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the scientific basis for policy decisions. Leaders at all levels of health and social care can use the evidence from SIR for the benefit of the patients and the population.
针对公共卫生和医疗保健系统特征的干预措施应能增进患者和人群的健康与福祉。
构建一个新框架，用于旨在评估公共卫生或医疗保健系统影响的研究，并考量随机对照试验（RCT）和基准对照试验（BCT）的作用。
这一新概念部分基于作者先前关于基准对照试验的论文。有效性和可推广性考量基于先前对RCT和BCT的方法学研究。
新的系统影响研究（SIR）概念涵盖所有旨在评估公共卫生系统或医疗保健系统对患者或人群影响的研究。系统影响研究中有两种研究类型：基准对照试验（观察性）和随机对照试验（实验性）。影响这一术语尤其涵盖可及性（可达性）、质量、有效性、安全性、效率和平等性。
系统影响研究——为政策决策奠定科学基础——在医学、公共卫生和卫生经济学研究中应被高度重视，也应用于提升绩效。各级卫生和社会护理领域的领导者可利用系统影响研究的证据造福患者和人群。关键信息 系统影响研究的新概念被定义为一个研究领域，旨在评估公共卫生、健康和社会护理系统的特征或试图改变这些特征的干预措施对患者和人群的影响。系统影响研究涵盖公共卫生、健康和社会护理系统的所有特征以及针对这些特征的行动。影响这一术语指公共卫生、健康和社会护理系统或其部分所造成的所有影响，特别强调服务的可及性、质量、有效性、不良反应、效率和平等性。系统影响研究为政策决策奠定科学基础。各级卫生和社会护理领域的领导者可利用系统影响研究的证据造福患者和人群。
