英国国家医疗服务系统（NHS）将择期医疗服务外包给独立机构对患者、医护人员和英国医疗系统的影响：快速文献综述。

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2024-09-16 DOI:10.1016/j.healthpol.2024.105166

Simon Fletcher , Oya Eddama , Michael Anderson , Rachel Meacock , Vasudha Wattal , Pauline Allen , Stephen Peckham

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引用次数: 0

摘要

国家医疗服务系统越来越多地转向独立部门，主要是为了缓解择期治疗的积压。然而，人们对其对医疗系统、患者和员工的影响还不甚了解。本文对独立部门（IS）中由国家医疗服务体系（NHS）资助的择期医疗的研究证据以及对患者、专业人员和医疗体系的影响进行了快速叙述性回顾。目的是确定文献的数量并评估其质量，同时提供一份叙述性综述。研究通过 Medline、CINAHL、Econlit、PubMed、Web of Science 和 Scopus 进行了识别。对所纳入研究的质量评估涉及研究设计、样本大小、相关性、方法和方法学优势、结果和结果报告以及偏倚风险。我们的综述包括 40 项质量参差不齐的研究。许多研究使用了定量数据来分析跨部门和部门间的结果趋势。独立医疗服务提供者（ISPs）可以提供与国家医疗服务体系质量相当的高容量、低复杂性的选择性医疗服务，同时在某些情况下还能减少候诊时间。但很明显，在独立部门提供由国民医疗服务体系（NHS）资助的选择性医疗服务会对公共医疗服务产生一系列影响。这些影响包括就医机会和结果的不平等、财务可持续性以及对国民医疗服务体系劳动力的影响。因此，未来的实证工作必须将这些注意事项纳入其中，从而对定量改进做出更细致的解释。

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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The impact of NHS outsourcing of elective care to the independent sector on outcomes for patients, healthcare professionals and the United Kingdom health care system: A rapid narrative review of literature

The NHS is increasingly turning to the independent sector, primarily to alleviate elective care backlogs. However, implications for the healthcare system, patients and staff are not well understood.

This paper provides a rapid narrative review of research evidence on NHS-funded elective care in the independent sector (IS) and the impact on patients, professionals, and the health care system. The aim was to identify the volume and evaluate the quality of the literature whilst providing a narrative synthesis.

Studies were identified through Medline, CINAHL, Econlit, PubMed, Web of Science and Scopus. The quality of the included studies was assessed in relation to study design, sample size, relevance, methodology and methodological strength, outcomes and outcome reporting, and risk of bias.

Our review included 40 studies of mixed quality. Many studies used quantitative data to analyse outcome trends across and between sectors. Independent sector providers (ISPs) can provide high-volume and low-complexity elective care of equivalent quality to the NHS, whilst reducing waiting times in certain contexts. However it is clear that the provision of NHS-funded elective care in the IS has a range of implications for public provision. These surround access and outcome inequalities, financial sustainability and NHS workforce impacts. It will subsequently be important for future empirical work to incorporate these caveats, providing a more nuanced interpretation of quantitative improvements.

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.