Translating economic evaluations into financing strategies for implementing evidence-based practices.
Translating economic evaluations into financing strategies for implementing evidence-based practices.
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DOI：
10.1186/s13012-021-01137-9
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发表时间：
2021-06-29
期刊：
影响因子：
--
通讯作者：
Raghavan R
中科院分区：
文献类型：
--
作者：
Dopp AR;Kerns SEU;Panattoni L;Ringel JS;Eisenberg D;Powell BJ;Low R;Raghavan R
实施研究人员越来越多地使用经济评估，以探讨在医疗保健环境中实施循证实践（EBP）所产生的好处。然而，典型的经济评估结果（例如，基于临床试验）很少足以为卫生服务组织和政策制定者如何为循证生物制品投资提供信息。本文介绍了如何通过对支持EBP实施和维持的融资战略的补充研究，将经济评估转化为政策和实践。我们提供了一个EBP实施融资的概述，其中概述了关键的融资和卫生服务提供系统的利益相关者和他们的决策点。然后，我们用三个案例说明了经济评估如何为EBP的实施和维持提供决策依据：（1）在美国科罗拉多服务不足的地区，部分基于经济评估证据的强度，使用“成功付费”融资实施多系统治疗;（2）美国医疗保险和医疗补助服务中心通过模拟经济影响开发的维持循证肿瘤治疗的替代支付模式;和（3）使用最近开发的财政映射过程，以配合在一个务实的临床试验，为阿片类药物使用障碍的新适应的家庭支持干预的融资策略和需求。EBP融资战略可以通过将经济评估结果转化为政策和实践，帮助克服与成本有关的障碍，以实施和维持EBP。我们提出了一个研究议程，以促进对融资战略的理解，在五个关键领域提出了我们的案例：（1）最大限度地提高现实世界的EBP实施的经济评估的相关性;（2）研究正在发生的变化，融资系统的经济评估的一部分;（3）确定条件下，一个给定的融资战略是最有益的;（4）探讨融资战略在实施前、积极实施和维持阶段的使用和影响;（5）通过与利益相关者团体建立强有力的伙伴关系推进研究工作，同时关注权力不平衡和透明度问题。对这些研究领域的关注将围绕EBP融资策略发展一个强大的奖学金体系，并最终使EBP对公共卫生产生更大的影响。
Implementation researchers are increasingly using economic evaluation to explore the benefits produced by implementing evidence-based practices (EBPs) in healthcare settings. However, the findings of typical economic evaluations (e.g., based on clinical trials) are rarely sufficient to inform decisions about how health service organizations and policymakers should finance investments in EBPs. This paper describes how economic evaluations can be translated into policy and practice through complementary research on financing strategies that support EBP implementation and sustainment. We provide an overview of EBP implementation financing, which outlines key financing and health service delivery system stakeholders and their points of decision-making. We then illustrate how economic evaluations have informed decisions about EBP implementation and sustainment with three case examples: (1) use of Pay-for-Success financing to implement multisystemic therapy in underserved areas of Colorado, USA, based in part on the strength of evidence from economic evaluations; (2) an alternative payment model to sustain evidence-based oncology care, developed by the US Centers for Medicare and Medicaid Services through simulations of economic impact; and (3) use of a recently developed fiscal mapping process to collaboratively match financing strategies and needs during a pragmatic clinical trial for a newly adapted family support intervention for opioid use disorder. EBP financing strategies can help overcome cost-related barriers to implementing and sustaining EBPs by translating economic evaluation results into policy and practice. We present a research agenda to advance understanding of financing strategies in five key areas raised by our case examples: (1) maximize the relevance of economic evaluations for real-world EBP implementation; (2) study ongoing changes in financing systems as part of economic evaluations; (3) identify the conditions under which a given financing strategy is most beneficial; (4) explore the use and impacts of financing strategies across pre-implementation, active implementation, and sustainment phases; and (5) advance research efforts through strong partnerships with stakeholder groups while attending to issues of power imbalance and transparency. Attention to these research areas will develop a robust body of scholarship around EBP financing strategies and, ultimately, enable greater public health impacts of EBPs.
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DOI：
10.15288/jsa.1996.57.229
发表时间：
1996-05-01
期刊：
JOURNAL OF STUDIES ON ALCOHOL
影响因子：
--
作者：
Finney, JW;Monahan, SC
通讯作者：
Monahan, SC
影响因子：
4.2
作者：
Brigham, Gregory S.;Slesnick, Natasha;Somoza, Eugene
通讯作者：
Somoza, Eugene
影响因子：
7.2
作者：
Dopp, Alex R.;Mundey, Peter;Eisenberg, Daniel
通讯作者：
Eisenberg, Daniel
影响因子：
5.7
作者：
Carlo, Andrew D.;Baden, Andrea Corage;Ratzliff, Anna D. H.
通讯作者：
Ratzliff, Anna D. H.
影响因子：
9.7
作者：
Decker, Sandra L.
通讯作者：
Decker, Sandra L.