Health and Social Care Workforce Research Unit, King's Policy Institute, King's College London, Virginia Woolf Building, 20 Kingsway, London, United Kingdom.
The Sax Institute, Sydney, NSW, Australia.
Health Res Policy Syst. 2024 Aug 19;22(1):113. doi: 10.1186/s12961-024-01187-7.
There is an often-held assumption that the engagement of clinicians and healthcare organizations in research improves healthcare performance at various levels. Previous reviews found up to 28 studies suggesting a positive association between the engagement of individuals and healthcare organizations in research and improvements in healthcare performance. The current study sought to provide an update.
We updated our existing published systematic review by again addressing the question: Does research engagement (by clinicians and organizations) improve healthcare performance? The search covered the period 1 January 2012 to March 2024, in two phases. First, the formal updated search ran from 1 January 2012 to 31 May 2020, in any healthcare setting or country and focussed on English language publications. In this phase two searches identified 66 901 records. Later, a further check of key journals and citations to identified papers ran from May 2020 to March 2024. In total, 168 papers progressed to full-text appraisal; 62 were identified for inclusion in the update. Then we combined papers from our original and updated reviews.
In the combined review, the literature is dominated by papers from the United States (50/95) and mostly drawn from the Global North. Papers cover various clinical fields, with more on cancer than any other field; 86 of the 95 papers report positive results, of which 70 are purely positive and 16 positive/mixed, meaning there are some negative elements (i.e. aspects where there is a lack of healthcare improvement) in their findings.
The updated review collates a substantial pool of studies, especially when combined with our original review, which are largely positive in terms of the impact of research engagement on processes of care and patient outcomes. Of the potential engagement mechanisms, the review highlights the important role played by research networks. The review also identifies various papers which consider how far there is a "dose effect" from differing amounts of research engagement. Additional lessons come from analyses of equity issues and negative papers. This review provides further evidence of contributions played by systems level research investments such as research networks on processes of care and patient outcomes.
人们常常认为，临床医生和医疗机构参与研究可以在各个层面上提高医疗保健水平。之前的综述发现，多达 28 项研究表明，个人和医疗机构参与研究与改善医疗保健绩效之间存在正相关关系。本研究旨在提供最新的证据。
我们通过再次回答以下问题来更新现有的系统综述：临床医生和组织的研究参与是否能改善医疗保健绩效？搜索涵盖了 2012 年 1 月至 2024 年 3 月期间，分为两个阶段。第一阶段，从 2012 年 1 月至 2020 年 5 月 31 日，在任何医疗保健环境或国家进行了正式的更新搜索，重点关注英语出版物。在此阶段，两次搜索共确定了 66901 条记录。后来，从 2020 年 5 月至 2024 年 3 月，对已确定论文的主要期刊和引文进行了进一步检查。总共 168 篇论文进入全文评估；确定了 62 篇论文进行更新。然后，我们将原始和更新综述中的论文合并在一起。
在合并的综述中，文献主要来自美国（50/95），且大多来自北欧。论文涵盖了各种临床领域，其中癌症领域的论文最多；95 篇论文中有 86 篇报告了积极的结果，其中 70 篇是纯粹积极的，16 篇是积极/混合的，这意味着他们的研究结果中有一些负面的因素（即存在缺乏医疗保健改善的方面）。
更新后的综述汇集了大量的研究，尤其是与我们的原始综述相结合时，这些研究在研究参与对护理过程和患者结果的影响方面大多是积极的。在潜在的参与机制中，综述强调了研究网络的重要作用。该综述还确定了一些论文，这些论文考虑了从不同程度的研究参与中是否存在“剂量效应”。从分析公平问题和负面论文中也得出了一些额外的经验教训。本综述提供了进一步的证据，证明了系统层面的研究投资，如研究网络，对护理过程和患者结果的贡献。
