Queensland University of Technology, Institute of Health and Biomedical Innovation, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia.
Appl Health Econ Health Policy. 2019 Aug;17(4):533-543. doi: 10.1007/s40258-019-00477-4.
There is a need for the application of theory in understanding the use of evidence from economic evaluations in healthcare decision making. The purpose of this study is to review the published literature on the use of evidence from economic evaluations for healthcare decision making and to map the findings to the Consolidated Framework for Implementation Research (CFIR).
A systematic search strategy was used to identify studies investigating the factors that determine the use of evidence from economic evaluation in healthcare decision making. Barriers and facilitators identified in the included studies were mapped across the five CFIR domains, with the "intervention" referring to the use of economic evaluations in decision making. Gaps, inconsistencies and emergent relations were identified through the mapping process.
Fifty-three studies met eligibility criteria and were included in the review. The CFIR constructs associated with the Intervention Characteristics and those associated with the knowledge and beliefs of users of economic evaluations were widely cited in the identified barriers and facilitators. Other constructs from the CFIR had not been reported in the literature, such as 'organisational networks' and 'individual stage of change'. Most of the stages in the implementation process as described by the CFIR were reflected in the identified barriers and facilitators.
By categorising barriers and facilitators into domains, the CFIR provides a systematic approach to assess how these factors interact. Literature gaps in the literature regarding the use of economic evaluation in healthcare decision making were identified, specifically issues regarding organisational networks and the role of feedback.
Through mapping findings from studies of the use of evidence from economic evaluations in healthcare decision making, we present an implementation framework based on the CFIR for understanding the use of economic evaluations into practice.
需要应用理论来理解经济评估证据在医疗保健决策中的使用。本研究旨在回顾已发表的关于使用经济评估证据进行医疗保健决策的文献，并将这些发现映射到实施研究综合框架（CFIR）上。
采用系统检索策略，以确定研究经济评估证据在医疗保健决策中的使用因素的研究。将纳入研究中确定的障碍和促进因素映射到 CFIR 的五个领域，其中“干预”是指在决策中使用经济评估。通过映射过程识别差距、不一致和新出现的关系。
符合纳入标准的 53 项研究被纳入综述。与干预特征相关的 CFIR 结构以及与经济评估使用者的知识和信念相关的结构在确定的障碍和促进因素中广泛引用。CFIR 中没有其他结构被文献报道，例如“组织网络”和“个人变革阶段”。CFIR 描述的实施过程中的大多数阶段都反映在确定的障碍和促进因素中。
通过将障碍和促进因素分类到各个领域，CFIR 提供了一种系统的方法来评估这些因素如何相互作用。在经济评估在医疗保健决策中的应用文献中发现了文献差距，特别是关于组织网络和反馈作用的问题。
通过将经济评估证据在医疗保健决策中的使用研究的结果映射到 CFIR 上，我们提出了一个基于 CFIR 的实施框架，用于理解经济评估在实践中的应用。
