Department of Economics, Management and Quantitative Methods (DEMM) and Center of Research and Advanced Education in Health Administration (CRC HEAD), Università Degli Studi Di Milano, Milan, Italy.
Department of Management & Law, Università Degli Studi Di Roma Tor Vergata, Rome, Italy.
BMC Health Serv Res. 2023 Sep 26;23(1):1029. doi: 10.1186/s12913-023-09935-1.
Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes.
Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement.
A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability.
The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records.
Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce.
Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement's actual impact on health care organizations' performance.
提高卫生系统的有效性、效率和适宜性是大多数国家的管理重点。学者和从业者关注医生的参与，以促进实现这些结果。
我们的研究旨在：1）阐明医生参与的定义；2）了解促进或阻碍其的因素；3）阐明医生参与对组织绩效、质量和安全的影响；4）讨论衡量医生参与的工具。
进行了范围综述。通过电子数据库搜索和滚雪球技术收集项目。遵循 PRISMA-ScR（范围综述的 PRISMA 扩展）声明和清单，以提高研究的可重复性。
搜索产生了 16062 条记录。经过初步筛选，有 300 项被选入本次文献综述。在去除重复项和不符合纳入标准的记录后，对 261 项记录进行了全文分析，共得到 174 项记录。
对医生参与的概念化存在共识，但学者对评估其实施和影响所使用的技术和方法存在分歧。已经提出了克服其采用障碍的建议，但关于实施医生参与的实证证据仍然很少。
我们的范围综述突出了现有关于医生参与文献的局限性。医生参与是一个相对定义不明确的概念：需要为其实际实施建立证据基础，以提供有关如何改进医疗保健组织治理的可靠指导。虽然我们没有评估当前实证研究的质量或稳健性，但我们的发现呼吁进一步研究：1）确定医生参与的潜在驱动因素，2）开发可靠的评估工具，为医疗保健组织提供关于如何促进医生参与的指导，3）评估参与对医疗保健组织绩效的实际影响。
