Lichten Catherine A, Marsden Grace, Pollitt Alexandra, Kiparoglou Vasiliki, Channon Keith M, Sussex Jon
RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, United Kingdom.
Office of Health Economics, Southside 7th floor, 105 Victoria Street, London, SW1E 6QT, United Kingdom.
Health Res Policy Syst. 2017 Jan 21;15(1):2. doi: 10.1186/s12961-016-0163-7.
Biomedical research can have impacts on patient care at research-active hospitals. We qualitatively evaluated the impact of the Oxford Biomedical Research Centre (Oxford BRC), a university-hospital partnership, on the effectiveness and efficiency of healthcare in local hospitals. Effectiveness and efficiency are conceptualised in terms of impacts perceived by clinicians on the quality, quantity and costs of patient care they deliver.
First, we reviewed documentation from Oxford BRC and literature on the impact of research activity on patient care. Second, we interviewed leaders of the Oxford BRC's research to identify the direct and indirect impacts they expected their activity would have on local hospitals. Third, this information was used to inform interviews with senior clinicians responsible for patient care at Oxford's acute hospitals to discover what impacts they observed from research generally and from Oxford BRC's research work specifically. We compared and contrasted the results from the two sets of interviews using a qualitative approach. Finally, we identified themes emerging from the senior clinicians' responses, and compared them with an existing taxonomy of mechanisms through which quality of healthcare may be affected in research-active settings.
We were able to interview 17 research leaders at the Oxford BRC and 19 senior clinicians at Oxford's acute hospitals. The research leaders identified a wide range of beneficial impacts that they expected might be felt at local hospitals as a result of their research activity. They expected the impact of their research activity on patient care to be generally positive. The senior clinicians responsible for patient care at those hospitals presented a more mixed picture, identifying many positive impacts, but also a smaller number of negative impacts, from research activity, including that of the Oxford BRC. We found the existing taxonomy of benefit types to be helpful in organising the findings, and propose modifications to further improve its usefulness.
Impacts from research activity on the effectiveness and efficiency of patient care at the local acute hospitals, as perceived by senior clinicians, were more often beneficial than harmful. The Oxford BRC contributed to those impacts.
生物医学研究可能会对开展研究的医院的患者护理产生影响。我们对牛津生物医学研究中心(Oxford BRC)这一大学与医院的合作机构对当地医院医疗保健的有效性和效率的影响进行了定性评估。有效性和效率是根据临床医生对他们所提供的患者护理的质量、数量和成本的感知影响来概念化的。
首先,我们查阅了牛津生物医学研究中心的文件以及关于研究活动对患者护理影响的文献。其次,我们采访了牛津生物医学研究中心的研究负责人,以确定他们预期其活动会对当地医院产生的直接和间接影响。第三,利用这些信息为对牛津急症医院负责患者护理的高级临床医生的访谈提供参考,以了解他们从一般研究以及特别是牛津生物医学研究中心的研究工作中观察到的影响。我们采用定性方法对两组访谈的结果进行比较和对比。最后,我们确定了高级临床医生回答中出现的主题,并将其与研究活跃环境中可能影响医疗质量的现有机制分类法进行比较。
我们能够采访牛津生物医学研究中心的17名研究负责人以及牛津急症医院的19名高级临床医生。研究负责人确定了他们预期其研究活动可能会在当地医院产生的广泛有益影响。他们预计其研究活动对患者护理的影响总体上是积极的。那些医院负责患者护理的高级临床医生呈现出更为复杂的情况,他们指出研究活动,包括牛津生物医学研究中心的研究活动,有许多积极影响,但也有较少的负面影响。我们发现现有的效益类型分类法有助于整理研究结果,并提出修改建议以进一步提高其有用性。
高级临床医生认为,研究活动对当地急症医院患者护理的有效性和效率的影响通常是有益而非有害的。牛津生物医学研究中心促成了这些影响。