Musiega Anita, Tsofa Benjamin, Barasa Edwine
Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Nairobi, 00100, Kenya.
Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Nairobi County, Kenya.
Wellcome Open Res. 2024 Oct 2;9:566. doi: 10.12688/wellcomeopenres.22533.1. eCollection 2024.
Effective Public Financial Management (PFM) approaches are imperative in the quest for efficiency in health service delivery. Reviews conducted in this area have assessed the impact of PFM approaches on health system efficiency but have left out the mechanisms through which PFM influences efficiency. This scoping review aims to synthesize evidence on the mechanisms by which PFM influences health system efficiency.
We searched databases of PubMed and Google Scholar and websites of the World Health Organization (WHO), World Bank and Overseas Development Institute (ODI) for peer-reviewed and grey literature articles that provided data on the relationship between PFM and health system efficiency. Three reviewers screened the articles for eligibility with the inclusion criteria. Data on PFM and health system efficiency was charted and summarized. We then reported the mechanisms by which PFM influence efficiency.
PFM processes and structures influence health system efficiency by influencing; the alignment of resources to health system needs, the cost of inputs, the motivation of health workers, and the input mix.
The entire budget process influences health system efficiency. However, most of the findings are drawn from studies that focused on aspects of the budget process. Studies that look at PFM in totality will help explore other cross-cutting issues within sections of the budget cycle; they will also bring out the relationship between the different phases of the budget cycle.
有效的公共财务管理（PFM）方法对于提高卫生服务提供效率至关重要。该领域已开展的综述评估了PFM方法对卫生系统效率的影响，但遗漏了PFM影响效率的机制。本范围综述旨在综合有关PFM影响卫生系统效率机制的证据。
我们检索了PubMed和谷歌学术数据库以及世界卫生组织（WHO）、世界银行和海外发展研究所（ODI）的网站，以查找提供PFM与卫生系统效率之间关系数据的同行评审和灰色文献文章。三名评审员根据纳入标准筛选文章的合格性。绘制并总结了有关PFM和卫生系统效率的数据。然后我们报告了PFM影响效率的机制。
PFM流程和结构通过影响资源与卫生系统需求的匹配、投入成本、卫生工作者的积极性以及投入组合来影响卫生系统效率。
整个预算过程会影响卫生系统效率。然而，大多数研究结果来自关注预算过程各个方面的研究。全面审视PFM的研究将有助于探索预算周期各部分内的其他交叉问题；它们还将揭示预算周期不同阶段之间的关系。
