Article type
Year
Abstract
Background: Rapid-learning health systems need to strongly rely on existing research evidence to make decisions about health system design, implementation and planning. Living reviews offer an outstanding opportunity to keep evidence up to date, which is a key issue for making decisions about health systems. Despite the relevance of having living evidence to make decisions, no living review on health systems research has been published.
Objectives: To summarize the existing evidence syntheses describing and evaluating a health system topic, in order to identify a topic for a living health systems review.
Methods: We conducted an overview of systematic reviews on payment mechanisms to organizations. We selected this topic because of the relevance of financial arrangements for health systems research, as well as the number of existing evidence syntheses already published. We searched four databases as well as grey literature. We extracted data to characterize the existing literature and used explicit criteria to assess quality. Finally, each one of the topics was assessed to analyze its potential to conduct a living review. Based on the existing publications of the Living Systematic Review network, we categorize each topic across the three criteria defined to when a living review is appropriate (namely a priority for decision making, certainty in the existing evidence, and the likelihood that new evidence becomes available).
Results: The preliminary results of this overview show that the main payment mechanisms used to fund organizations (fee-for-service, capitation, case-based and global budgets) are a priority for decision-making, and its certainty in the existing evidence is generally low or very low. However, different payment mechanisms differ in the probability that new evidence could be published, changing the existing conclusion.
Conclusions: An essential component of rapid-learning health systems is to count on living evidence to make constant transformations. This presentation shows a concrete method to identify topics where living health systems reviews might be needed.
Patient or healthcare consumer involvement: To incorporate consumers and patients’ perspectives, the results of this overview of systematic reviews need to be presented to relevant stakeholders to receive important feedback. This brings special insights on how health systems living reviews can be an essential tool for rapid-learning health systems.
Objectives: To summarize the existing evidence syntheses describing and evaluating a health system topic, in order to identify a topic for a living health systems review.
Methods: We conducted an overview of systematic reviews on payment mechanisms to organizations. We selected this topic because of the relevance of financial arrangements for health systems research, as well as the number of existing evidence syntheses already published. We searched four databases as well as grey literature. We extracted data to characterize the existing literature and used explicit criteria to assess quality. Finally, each one of the topics was assessed to analyze its potential to conduct a living review. Based on the existing publications of the Living Systematic Review network, we categorize each topic across the three criteria defined to when a living review is appropriate (namely a priority for decision making, certainty in the existing evidence, and the likelihood that new evidence becomes available).
Results: The preliminary results of this overview show that the main payment mechanisms used to fund organizations (fee-for-service, capitation, case-based and global budgets) are a priority for decision-making, and its certainty in the existing evidence is generally low or very low. However, different payment mechanisms differ in the probability that new evidence could be published, changing the existing conclusion.
Conclusions: An essential component of rapid-learning health systems is to count on living evidence to make constant transformations. This presentation shows a concrete method to identify topics where living health systems reviews might be needed.
Patient or healthcare consumer involvement: To incorporate consumers and patients’ perspectives, the results of this overview of systematic reviews need to be presented to relevant stakeholders to receive important feedback. This brings special insights on how health systems living reviews can be an essential tool for rapid-learning health systems.