College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Health Policy. 2022 Oct;126(10):1051-1061. doi: 10.1016/j.healthpol.2022.08.008. Epub 2022 Aug 18.
Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms.
A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018. Data from 85 interviews with AHC leaders, clinicians and researchers, direct observation, and documentation were analysed within and across the cases.
Comparison across cases produced four cross-case themes: health care rather than population health; incremental rather than major health system change; different conceptions of "translation" and "innovation"; and unclear pathways to impact. The ability of the AHCs to define and enact a population health role was hindered during the study period by gaps in knowledge mobilisation strategies at a health system and policy level, the biomedical orientation of government designation schemes for AHCs in Australia and England, and competing expectations of the sovereign partner organisations in AHCs against a backdrop of limited operational resources.
The study identifies several institutional elements that are likely to be needed for AHCs in Australia and England to deliver on both internal and external expectations of their population health role.
学术健康中心（AHCs）是旨在通过提高卫生系统对新出现证据的响应能力来将知识转化为实践的组织。本研究旨在探索 AHC 在澳大利亚和英国的人口健康作用，在这两个国家，AHC 代表了新颖的组织形式。
采用定性方法的多案例研究设计，于 2017 年至 2018 年期间在两国的四个不同 AHC 中探索人口健康目标和活动。对来自 AHC 领导者、临床医生和研究人员的 85 次访谈、直接观察和文件资料进行了分析，分析过程既在各案例内进行，也在各案例间进行。
对各案例进行比较得出了四个跨案例主题：关注医疗保健而非人口健康；渐进而非重大的卫生系统变革；对“转化”和“创新”的不同理解；以及影响的途径不明确。在研究期间，由于知识转化策略在卫生系统和政策层面上的空白、澳大利亚和英国 AHC 政府指定计划的生物医学定位，以及 AHC 中主权伙伴组织的竞争期望，以及有限的运营资源背景下，AHC 定义和实施人口健康角色的能力受到阻碍。
本研究确定了澳大利亚和英国的 AHC 可能需要的几个制度要素，以满足其内部和外部对其人口健康角色的期望。
