Hanney Stephen R, González-Block Miguel A
Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK.
Universidad Anáhuac, Av. Universidad Anáhuac 46, Lomas Anáhuac, 52786, Huixquilucan, Mexico City, Mexico.
Health Res Policy Syst. 2016 Dec 28;14(1):90. doi: 10.1186/s12961-016-0160-x.
In 2016, England's National Institute for Health Research (NIHR) celebrated its tenth anniversary as an innovative national health research system with a focus on meeting patients' needs. This provides a good opportunity to reflect on how the creation of the NIHR has greatly enhanced important work, started in 1991, to develop a health research system in England that is embedded in the National Health Service.In 2004, WHO identified a range of functions that a national health research system should undertake to improve the health of populations. Health Research Policy and Systems (HRPS) has taken particular interest in the pioneering developments in the English health research system, where the comprehensive approach has covered most, if not all, of the functions identified by WHO. Furthermore, several significant recent developments in thinking about health research are relevant for the NIHR and have informed accounts of its achievements. These include recognition of the need to combat waste in health research, which had been identified as a global problem in successive papers in the Lancet, and an increasing emphasis on demonstrating impact. Here, pioneering evaluation of United Kingdom research, conducted through the impact case studies of the Research Excellence Framework, is particularly important. Analyses informed by these and other approaches identified many aspects of NIHR's progress in combating waste, building and sustaining research capacity, creating centres of research excellence linked to leading healthcare institutions, developing research networks, involving patients and others in identifying research needs, and producing and adopting research findings that are improving health outcomes.The NIHR's overall success, and an analysis of the remaining problems, might have lessons for other systems, notwithstanding important advances in many countries, as described in papers in HRPS and elsewhere. WHO's recently established Global Observatory for Health Research and Development provides an opportunity to promote some of these lessons. To inform its work, the Observatory is sponsoring a thematic series of papers in HRPS focusing on health research issues such as funding flows, priority setting, capacity building, utilisation and equity. While important papers on these have been published, this series is still open to new submissions.
2016年,英国国家卫生研究院(NIHR)迎来了其作为一个以满足患者需求为重点的创新性国家卫生研究系统的十周年庆典。这提供了一个很好的契机,来反思NIHR的创建如何极大地推动了始于1991年的一项重要工作,即在英国建立一个融入国民医疗服务体系的卫生研究系统。2004年,世界卫生组织确定了国家卫生研究系统为改善民众健康应承担的一系列职能。卫生研究政策与系统(HRPS)对英国卫生研究系统的开创性发展尤为关注,在该系统中,其全面的方法涵盖了世界卫生组织确定的大部分(即便不是全部)职能。此外,近期有关卫生研究的一些重要进展与NIHR相关,并为阐述其成就提供了依据。这些进展包括认识到需要在卫生研究中杜绝浪费现象,《柳叶刀》杂志的一系列文章已将此确定为一个全球性问题,以及越来越强调展示影响力。在此,通过卓越研究框架的影响力案例研究对英国研究进行的开创性评估尤为重要。基于这些及其他方法的分析确定了NIHR在杜绝浪费、建设和维持研究能力、创建与领先医疗机构相关的卓越研究中心、发展研究网络、让患者及其他各方参与确定研究需求以及产生并采用改善健康结果的研究成果等方面取得进展的诸多方面。NIHR的总体成功以及对尚存问题的分析,可能会给其他系统带来启示,尽管正如HRPS及其他地方的论文所述,许多国家已取得了重要进展。世界卫生组织最近设立全球卫生研究与发展观察站,为推广其中一些经验教训提供了契机。为指导其工作,该观察站正在HRPS赞助一系列专题论文,重点关注诸如资金流动、确定优先事项、能力建设、利用和公平等卫生研究问题。虽然关于这些问题的重要论文已经发表,但该系列仍接受新的投稿。