背景:研究活动通常通过转化为实践来改善结果。然而,有越来越多的证据表明,研究活动本身可能会提高医疗保健组织的整体绩效。然而,这些关系代表研究活动的因果影响的证据不太清楚。此外,现有的大部分证据与医院环境有关,不知道这些关系是否也会在一般实践中找到,大多数患者接触的地方。
目的:我们试图(a)测试一般实践中的研究活动与组织绩效之间是否存在显着关系(b)测试这些关系是否具有因果关系。
方法:我们使用横截面和纵向分析分析了2008年至2019年的国家数据,关于英国的一般做法。
方法:我们使用横截面,小组和工具变量分析,以探索研究活动(包括NIHR临床研究网络和皇家全科医师学院的措施)与实践绩效(包括临床护理质量,患者报告的护理经验,处方质量和住院人数)结果:在横断面分析中,研究活动与实践绩效的几种衡量标准呈正相关,包括临床护理质量,患者报告的护理经验,减少住院人数。这些协会的规模通常不大。然而,纵向分析不支持可靠的因果关系.
结论:类似于医院环境的发现,一般实践中的研究活动与实践表现有关。很少有证据表明研究正在导致这些改善,尽管这可能反映了大多数实践中研究活动的有限水平。我们没有发现负面影响,表明研究活动是质量的潜在标志,高质量的实践可以与他们的核心责任一起交付。
BACKGROUND: Research activity usually improves outcomes by being translated into practice. However, there is developing evidence that research activity itself may improve the overall performance of health care organisations. However, evidence that these relationships represent a causal impact of research activity is less clear. Additionally, the bulk of the existing evidence relates to hospital settings, and it is not known if those relationships would also be found in general practice, where most patient contacts occur.
OBJECTIVE: We sought to (a) test whether there were significant relationships between research activity in general practice and organisational performance (b) test whether those relationships were plausibly causal.
METHODS: We analysed national data between 2008 and 2019 using cross sectional and longitudinal analyses, on general practices in England.
METHODS: We used cross-sectional, panel and instrumental variable analyses to explore relationships between research activity (including measures from the NIHR Clinical Research Network and the Royal College of General Practitioners) and practice performance (including clinical quality of care, patient reported experience of care, prescribing quality and hospital admissions) Results: In cross-sectional analyses, research activity was positively associated with several measures of practice performance, including clinical quality of care, patient reported experience of care, and reduced hospital admissions. The associations were generally modest in magnitude. However, longitudinal analyses did not support a reliable causal relationship.
CONCLUSIONS: Similar to findings from hospital settings, research activity in general practice is associated with practice performance. There is less evidence that research is causing those improvements, although this may reflect the limited level of research activity in most practices. We identified no negative impacts, suggesting that research activity is a potential marker of quality and something that high quality practices can deliver alongside their core responsibilities.