Ahmadi Ayat, Doshmangir Leila, Majdzadeh Reza
Knowledge Utilization Research Center Tehran University of Medical Sciences Tehran Iran.
Social Determinants of Health Research Center Tabriz University of Medical Sciences Tabriz Iran.
Learn Health Syst. 2023 Mar 16;8(1):e10363. doi: 10.1002/lrh2.10363. eCollection 2024 Jan.
The health systems needed to improve their learning capacities during the COVID-19 pandemic. Iran is one of the countries massively struck by the pandemic. This study aimed to explore whether and how the policy interventions made by Iran's policymakers at the national level to control COVID-19, could improve the rapid learning characteristics of the health system.
A guide to clarify rapid learning health system (RLHS) characteristics was developed. The guide was used by two independent authors to select the policy interventions that could improve RLHS characteristics, then, to analyze the content of the selected policy interventions. In each stage, results were compared and discussed by all three authors. Final results were presented based on different RLHS characteristics and the potential mechanisms of contribution.
Five hundred policy interventions were developed during the first 7 months of the outbreak. Thirty-one policy interventions could potentially improve RLHS characteristics (6.2%). Two characteristics, such as the timely production of research evidence and the appropriate decision support were addressed by selected policy interventions. Policies, that could improve learning capacities, focused on decision-maker groups more than user groups or researcher groups.
Most of the developed policy interventions during the first months of the epidemic did not address the learning capacities of the health system. To improve health system functions, improving RLHS characteristics of the health system, especially in patient-centered and data linkage characteristics, is recommended.
在新冠疫情期间，卫生系统需要提升其学习能力。伊朗是受疫情重创的国家之一。本研究旨在探讨伊朗政策制定者在国家层面为控制新冠疫情所采取的政策干预措施是否以及如何能够提升卫生系统的快速学习特性。
制定了一份用于阐明快速学习卫生系统（RLHS）特性的指南。两位独立作者使用该指南来挑选能够改善RLHS特性的政策干预措施，然后分析所选政策干预措施的内容。在每个阶段，三位作者都会对结果进行比较和讨论。最终结果基于不同的RLHS特性及其潜在的贡献机制呈现。
在疫情爆发的前7个月里共制定了500项政策干预措施。其中31项政策干预措施有可能改善RLHS特性（6.2%）。所选政策干预措施涉及了两个特性，如研究证据的及时产出和适当的决策支持。能够提升学习能力的政策更多地关注决策者群体，而非用户群体或研究人员群体。
疫情最初几个月制定的大多数政策干预措施并未涉及卫生系统的学习能力。为改善卫生系统功能，建议提升卫生系统的RLHS特性，尤其是以患者为中心和数据关联特性。
