Browne John P
University College Cork, Cork, Ireland.
Future Healthc J. 2020 Feb;7(1):33-37. doi: 10.7861/fhj.2019-0065.
Ireland, like many countries, has reconfigured emergency care in recent years towards a more centralised model. Although centralisation is presented as 'evidence-based', the relevance of this evidence is challenged by groups which hold values beyond those implicit in the literature. The Study of the Impact of Reconfiguration on Emergency and Urgent Care Networks (SIREN) programme was funded to evaluate the development and performance of emergency and urgent care systems in Ireland. SIREN found that the drivers of reconfiguration in Ireland are based on safety and efficiency claims which are highly contestable. Reconfiguration was not associated with improvements in safety or efficiency and may have exacerbated the growing capacity challenges for acute hospitals. These findings are consistent with UK research. Our study adds to an emerging literature on the interaction between a narrow technocratic approach to health system planning and the perspectives of the public and patients.
与许多国家一样，爱尔兰近年来已将紧急护理重新配置为更集中的模式。尽管集中化被视为“基于证据”，但持有文献中未隐含价值观的群体对这一证据的相关性提出了质疑。重新配置对急诊和紧急护理网络的影响研究（SIREN）项目获得资助，以评估爱尔兰急诊和紧急护理系统的发展与绩效。SIREN发现，爱尔兰重新配置的驱动因素基于极具争议性的安全和效率主张。重新配置与安全或效率的改善并无关联，而且可能加剧了急症医院日益增长的容量挑战。这些发现与英国的研究一致。我们的研究为关于卫生系统规划中狭隘技术官僚方法与公众及患者观点之间相互作用的新兴文献增添了内容。
