The ecosystem of health decision making: from fragmentation to synergy
Por:
Schünemann H.J., Reinap M., Piggott T., Laidmäe E., Köhler K., Pold M., Ens B., Irs A., Akl E.A., Cuello C.A., Falavigna M., Gibbens M., Neamtiu L., Parmelli E., Jameleddine M., Pyke L., Verstijnen I., Alonso-Coello P., Tugwell P., Zhang Y., Saz-Parkinson Z., Kuchenmüller T., Moja L.
Publicada:
1 abr 2022
Resumen:
Clinicians, patients, policy makers, fenders, programme managers, regulators, and science communities invest considerable amounts of time and energy in influencing or making decisions at various levels, using systematic reviews, health technology assessments, guideline recommendations, coverage decisions, selection of essential medicines and diagnostics, quality assurance and improvement schemes, and policy and evidence briefs. The criteria and methods that these actors use in their work differ (eg, the role economic analysis has in decision making), but these methods frequently overlap and exist together. Under the aegis of WHO, we have brought together representatives of different areas to reconcile how the evidence that influences decisions is used across multiple health system decision levels. We describe the overlap and differences in decision-making criteria between different actors in the health sector to provide bridging opportunities through a unifying broad framework that we call theory of everything. Although decision-making activities respond to system needs, processes are often poorly coordinated, both globally and on a country level. A decision made in isolation from other decisions on the same topic could cause misleading, unnecessary, or conflicted inputs to the health system and, therefore, confusion and resource waste.
Filiaciones:
Schünemann H.J.:
Michael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada
Dipartimento di Scienze Biomediche, Humanitas University, Milan, Italy
Reinap M.:
Division of Country Health Policies and Systems, WHO Regional Office for Europe, Copenhagen, Denmark
Piggott T.:
Michael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada
Laidmäe E.:
Department of Medicines and Medical Devices, Estonian Health Insurance Fund, Tallinn, Estonia
Köhler K.:
WHO Country Office in Estonia, World Health Organization, Tallinn, Estonia
Pold M.:
Institute of Family Medicine and Public Health, Health Technology Assessment Unit, University of Tartu, Tartu, Estonia
Ens B.:
Canadian Agency for Drugs and Technology in Health, Ottawa, ON, Canada
Irs A.:
State Agency of Medicines of Estonia, Tartu, Estonia
Heart Clinic, Tartu University Hospital, Tartu, Estonia
Akl E.A.:
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Cuello C.A.:
Michael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada
Canadian Agency for Drugs and Technology in Health, Ottawa, ON, Canada
Falavigna M.:
National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
Gibbens M.:
Canadian Agency for Drugs and Technology in Health, Ottawa, ON, Canada
Neamtiu L.:
Joint Research Centre, European Commission, Ispra, Italy
Parmelli E.:
Joint Research Centre, European Commission, Ispra, Italy
Jameleddine M.:
Health Technology Assessment Department, National Authority for Assessment and Accreditation in Healthcare, Tunis, Tunisia
Pyke L.:
Canadian Agency for Drugs and Technology in Health, Ottawa, ON, Canada
Verstijnen I.:
Research and Development, International Affairs, National Health Care Institute, Diemen, Netherlands
Alonso-Coello P.:
Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau-CIBERESP, Barcelona, Spain
Centro GRADE Barcelona, Barcelona, Spain
Tugwell P.:
Department of Medicine, University of OttawaON, Canada
Zhang Y.:
Michael G. DeGroote Cochrane Canada Centre and McMaster GRADE Centres, Department of Health Research Methods, Evidence, and Impact, Department of Medicine, WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, ON, Canada
Saz-Parkinson Z.:
Health Technology Assessment Agency, Instituto de Salud Carlos III, Madrid, Spain
Kuchenmüller T.:
Department of Research for Health, WHO, Geneva, Switzerland
Moja L.:
Department of Health Product Policy and Standards, WHO, Geneva, Switzerland
Green Published, gold, Gold, Green
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