医疗创新对医疗机构绩效的可衡量结果有何影响？系统回顾

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations Pub Date : 2024-01-10 DOI:10.1136/bmjinnov-2023-001097

Caoimhe Madden, Róisín O'Malley, Emily O'Dowd, Paul O'Connor, Sinéad Lydon, Jared Gormly, Dara Byrne

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引用次数: 0

摘要

目标缺乏有效性的定量证据一直被认为是医疗创新的启动和推广过程中的一个明显缺陷。因此，本综述旨在综合评估医疗创新对医疗机构绩效可衡量结果的影响的研究。设计根据《系统综述和元分析首选报告项目》指南进行了系统综述。数据来源在 MEDLINE、CINAHL 和 PsycINFO 三个电子数据库中进行了系统检索。选择研究的资格标准文章必须具备以下条件(a) 自 2000 年以来发表在同行评审的英文期刊上；(b) 描述了在二级医疗机构中应用特定创新的情况；(c) 使用符合 Kirkpatrick 评价等级体系第四级的结果衡量标准（即组织绩效衡量标准），报告创新对医疗结果影响的总结性评价数据；(d) 研究设计允许通过比较对象来评价创新对结果衡量标准的影响。结果以组织变革为目标的创新最常见。创新通常会产生积极影响，这在所纳入文章的近三分之二的成果评估指标中都很明显。创新的影响主要通过健康利用指标和医疗临床指标来衡量，而安全结果和患者/家属的看法则较少被评估。结论有证据表明，创新能明显改变组织的重要性，包括财务和医疗利用率等重要指标。建议采用捆绑式结果测量，以更全面地反映创新对医疗机构绩效的真实影响。如有合理要求，可提供相关数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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What is the impact of healthcare innovation on measurable outcomes of healthcare organisation performance? A systematic review

Objective The lack of quantitative evidence of effectiveness has been cited as a notable shortcoming of initiation and diffusion of innovations in healthcare. Therefore, this review aimed to synthesise research assessing the impact of healthcare innovations on measurable outcomes of healthcare organisation performance. Design A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources Systematic searches were conducted across three electronic databases, namely MEDLINE, CINAHL and PsycINFO. Eligibility criteria for selecting studies Articles were required to: (a) be published in an English-language, peer-reviewed journal since 2000; (b) describe the application of a specific innovation within a secondary healthcare setting; (c) report data on the summative evaluation of the impact of the innovation on healthcare outcomes, using an outcome measure in line with Level Four of Kirkpatrick’s Evaluation Hierarchy (ie, a measure of organisation performance) and (d) consist of a research design that allowed for evaluation of innovation impact on outcome measures by means of a comparator. Results Innovations targeting organisational change were most commonly implemented. Innovations generally had a positive impact, evident in almost two-thirds of the outcome measures assessed across the included articles. Innovation impact was predominantly measured via health utilisation metrics and medical-clinical indicators, with safety outcomes and patient/family perceptions less frequently assessed. Conclusion There is evidence to show that innovations result in discernible change in organisational importance, including on important metrics such as finance and healthcare utilisation. Bundling outcome measures are recommended to provide a more complete picture of the true impact of innovation on healthcare organisation performance. Data are available on reasonable request.

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来源期刊

BMJ Innovations Medicine-Medicine (all)

CiteScore

4.20

自引率

0.00%

发文量

期刊介绍： Healthcare is undergoing a revolution and novel medical technologies are being developed to treat patients in better and faster ways. Mobile revolution has put a handheld computer in pockets of billions and we are ushering in an era of mHealth. In developed and developing world alike healthcare costs are a concern and frugal innovations are being promoted for bringing down the costs of healthcare. BMJ Innovations aims to promote innovative research which creates new, cost-effective medical devices, technologies, processes and systems that improve patient care, with particular focus on the needs of patients, physicians, and the health care industry as a whole and act as a platform to catalyse and seed more innovations. Submissions to BMJ Innovations will be considered from all clinical areas of medicine along with business and process innovations that make healthcare accessible and affordable. Submissions from groups of investigators engaged in international collaborations are especially encouraged. The broad areas of innovations that this journal aims to chronicle include but are not limited to: Medical devices, mHealth and wearable health technologies, Assistive technologies, Diagnostics, Health IT, systems and process innovation.