Searles Andrew, Piper Donella, Jorm Christine, Reeves Penny, Gleeson Maree, Karnon Jonathan, Goodwin Nicholas, Lawson Kenny, Iedema Rick, Gray Jane
Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia.
New South Wales Regional Health Partners, Newcastle, Australia.
BMC Health Serv Res. 2021 Mar 6;21(1):201. doi: 10.1186/s12913-021-06181-1.
Systematic approaches to the inclusion of economic evaluation in national healthcare decision-making are usual. It is less common for economic evaluation to be routinely undertaken at the 'local-level' (e.g. in a health service or hospital) despite the largest proportion of health care expenditure being determined at this service level and recognition by local health service decision makers of the need for capacity building in economic evaluation skills. This paper describes a novel program - the embedded Economist (eE) Program. The eE Program aims to increase local health service staff awareness of, and develop their capacity to access and apply, economic evaluation principles in decision making. The eE program evaluation is also described. The aim of the evaluation is to capture the contextual, procedural and relational aspects that assist and detract from the eE program aims; as well as the outcomes and impact from the specific eE projects.
The eE Program consists of a embedding a health economist in six health services and the provision of supported education in applied economic evaluation, provided via a community of practice and a university course. The embedded approach is grounded in co-production, embedded researchers and 'slow science'. The sites, participants, and program design are described. The program evaluation includes qualitative data collection via surveys, semi-structured interviews, observations and field diaries. In order to share interim findings, data are collected and analysed prior, during and after implementation of the eE program, at each of the six health service sites. The surveys will be analysed by calculating frequencies and descriptive statistics. A thematic analysis will be conducted on interview, observation and filed diary data. The Framework to Assess the Impact from Translational health research (FAIT) is utilised to assess the overall impact of the eE Program.
This program and evaluation will contribute to knowledge about how best to build capacity and skills in economic evaluation amongst decision-makers working in local-level health services. It will examine the extent to which participants are able to improve their ability to utilise evidence to inform decisions, avoid waste and improve the value of care delivery.
在国家医疗保健决策中纳入经济评估的系统方法很常见。尽管大部分医疗保健支出是在“地方层面”（如在卫生服务机构或医院）确定的，且地方卫生服务决策者也认识到经济评估技能能力建设的必要性，但在地方层面常规开展经济评估的情况却较少见。本文介绍了一个新颖的项目——嵌入式经济学家（eE）项目。eE项目旨在提高地方卫生服务人员对经济评估原则的认识，并培养他们在决策中获取和应用这些原则的能力。本文还描述了eE项目评估。评估的目的是了解有助于和阻碍eE项目目标实现的背景、程序和关系方面的情况；以及特定eE项目的成果和影响。
eE项目包括在六个卫生服务机构中派驻一名卫生经济学家，并通过实践社区和大学课程提供应用经济评估方面的支持性教育。这种嵌入式方法以共同生产、嵌入式研究人员和“慢科学”为基础。文中描述了项目地点、参与者和项目设计。项目评估包括通过调查、半结构化访谈、观察和实地日记收集定性数据。为了分享中期研究结果，在eE项目实施前、实施期间和实施后，在六个卫生服务机构中的每一个机构收集并分析数据。调查将通过计算频率和描述性统计进行分析。将对访谈、观察和实地日记数据进行主题分析。利用转化性健康研究影响评估框架（FAIT）来评估eE项目的总体影响。
该项目及其评估将有助于了解如何最好地在地方层面卫生服务机构工作的决策者中建立经济评估能力和技能。它将研究参与者在多大程度上能够提高利用证据为决策提供信息、避免浪费和提高医疗服务价值的能力。
