Roseleur Jacqueline, Partington Andrew, Karnon Jonathan
School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, Australia.
JBI Evid Synth. 2020 Jan;18(1):128-134. doi: 10.11124/JBISRIR-D-19-00094.
The aim of this review is to identify and describe the evidence base of published primary, comparative healthcare delivery model evaluations that require the employment of additional healthcare practitioners undertaken in Australia.
In Australia, formal processes are utilized in assessing the value of new pharmaceuticals and medical services, which inform decisions on whether to list new items on the Pharmaceutical Benefits Schedule and Medicare Benefits Schedule, respectively. There are no formal processes to aid in decision making on the funding of new, evaluated healthcare delivery models. This imbalance undervalues the available evidence on healthcare delivery models, leading to the sub-optimal allocation of resources between new health technologies and new healthcare delivery models within the Australian health system.
Eligible studies will evaluate healthcare delivery models that require the employment of additional healthcare practitioners (either to replace existing practitioners of another type or to provide new services). Studies must include a comparator to evaluate a condition of interest being treated using alternative healthcare delivery models, or no treatment, and will involve observation of outcomes over a similar period of time. Studies in any Australian setting will be included. Interventions aimed at primary preventions will be excluded.
PubMed, Embase and CINAHL will be searched for articles published from 2008. One reviewer will review titles, and then two reviewers will independently review abstracts to identify eligible studies. One reviewer will extract data on study characteristics and design. The results of the data extraction will be presented in a table with examples of case studies.
本综述的目的是识别并描述已发表的主要的、比较性医疗服务提供模式评估的证据基础，这些评估需要在澳大利亚雇佣额外的医疗从业者。
在澳大利亚，评估新药品和医疗服务价值时会采用正式流程，这些流程分别为药品福利计划和医疗保险福利计划上是否列入新项目的决策提供依据。但在为新的、经过评估的医疗服务提供模式提供资金的决策方面，却没有正式流程。这种不平衡低估了医疗服务提供模式的现有证据，导致澳大利亚卫生系统在新卫生技术和新医疗服务提供模式之间的资源分配不尽如人意。
符合条件的研究将评估需要雇佣额外医疗从业者的医疗服务提供模式（要么替代另一种类型的现有从业者，要么提供新服务）。研究必须包括一个对照，以评估使用替代医疗服务提供模式或不进行治疗来治疗感兴趣病症的情况，并且将涉及在相似时间段内对结果的观察。将纳入澳大利亚任何环境下的研究。旨在进行一级预防的干预措施将被排除。
将检索PubMed、Embase和CINAHL中2008年以来发表的文章。一名评审员将审阅标题，然后两名评审员将独立审阅摘要以确定符合条件的研究。一名评审员将提取关于研究特征和设计的数据。数据提取结果将以表格形式呈现，并附有案例研究示例。
