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36个多项目研究计划对医疗保健、政策及实践的影响:两项综述的结果

The impact on healthcare, policy and practice from 36 multi-project research programmes: findings from two reviews.

作者信息

Hanney Steve, Greenhalgh Trisha, Blatch-Jones Amanda, Glover Matthew, Raftery James

机构信息

Health Economics Research Group (HERG), Institute of Environment, Health and Societies, Brunel University London, London, UB8 3PH, United Kingdom.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, United Kingdom.

出版信息

Health Res Policy Syst. 2017 Mar 28;15(1):26. doi: 10.1186/s12961-017-0191-y.

Abstract

BACKGROUND

We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects.

METHODS

We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared.

RESULTS

Included programmes were highly diverse in terms of location (11 different countries plus two multi-country ones), number of component projects (8 to 178), nature of the programme, research field, mode of funding, time between completion and impact assessment, methods used to assess impact, and level of impact identified. Thirty-one studies reported on policy impact, 17 on clinician behaviour or informing clinical practice, three on a combined category such as policy and clinician impact, and 12 on wider elements of impact (health gain, patient benefit, improved care or other benefits to the healthcare system). In those multi-programme projects that assessed the respective categories, the percentage of projects that reported some impact was policy 35% (range 5-100%), practice 32% (10-69%), combined category 64% (60-67%), and health gain/health services 27% (6-48%). Variations in levels of impact achieved partly reflected differences in the types of programme, levels of collaboration with users, and methods and timing of impact assessment. Most commonly, principal investigators were surveyed; some studies involved desk research and some interviews with investigators and/or stakeholders. Most studies used a conceptual framework such as the Payback Framework. One study attempted to assess the monetary value of a research programme's health gain.

CONCLUSION

The widespread impact reported for some multi-project programmes, including needs-led and collaborative ones, could potentially be used to promote further research funding. Moves towards greater standardisation of assessment methods could address existing inconsistencies and better inform strategic decisions about research investment; however, unresolved issues about such moves remain.

摘要

背景

我们试图分析在一系列由多个项目组成的卫生研究计划和项目组合评估中所发现的影响以及所使用的方法。

方法

我们从2007年和2016年发表的两篇叙述性系统评价中纳入的更广泛的影响研究样本中,选取了36项多项目研究计划的影响研究样本。我们纳入了那些对计划中的各个项目进行了更广泛影响评估的影响研究,特别是对政策或实践的影响,并且研究结果的描述方式允许对其进行整理和比较。

结果

纳入的计划在地点(11个不同国家加上两个多国计划)、组成项目数量(8至178个)、计划性质、研究领域、资助模式、完成与影响评估之间的时间、用于评估影响的方法以及所确定的影响水平等方面高度多样化。31项研究报告了政策影响,17项报告了对临床医生行为或为临床实践提供信息的影响,3项报告了如政策和临床医生影响等综合类别,12项报告了更广泛的影响要素(健康改善、患者受益、护理改善或对医疗保健系统的其他益处)。在那些评估各自类别的多项目计划中,报告有某种影响的项目百分比分别为:政策35%(范围为5 - 100%)、实践32%(10 - 69%)、综合类别64%(60 - 67%)以及健康改善/卫生服务27%(6 - 48%)。所实现的影响水平差异部分反映了计划类型、与用户的合作水平以及影响评估方法和时间的差异。最常见的是对主要研究者进行调查;一些研究涉及案头研究,一些涉及对研究者和/或利益相关者的访谈。大多数研究使用了诸如回报框架之类的概念框架。一项研究试图评估研究计划的健康改善的货币价值。

结论

一些多项目计划,包括需求导向型和合作型计划,所报告的广泛影响可能会被用于促进进一步的研究资金投入。朝着评估方法更大程度标准化的方向发展可以解决现有的不一致问题,并为有关研究投资的战略决策提供更好的信息;然而,关于此类举措的未解决问题仍然存在。

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