| 引用本文：Reza Majdzadeh,Bahareh Yazdizadeh,Saharnaz Nedjat,等.加强循证决策：不改善卫生系统管理，可能吗？[J].中国卫生政策研究,2012,5(5):3-8 |
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| 加强循证决策：不改善卫生系统管理，可能吗？ |
| 投稿时间：2012-03-20 修订日期：2012-04-22 PDF全文浏览 HTML全文浏览 |
| Reza Majdzadeh1, Bahareh Yazdizadeh1, Saharnaz Nedjat1, Jaleh Gholami1, Sharareh Ahghari1 |
| 德黑兰医科大学公共卫生学院 |
| 摘要:背景：世界范围内的卫生系统都面临资源限制。因此，通过科学循证决策来削减成本并防止资源浪费非常重要和必要，本研究旨在分析伊朗卫生系统循证决策的障碍。方法：通过对决策者的深度访谈和焦点小组讨论收集数据，共进行了13次访谈和6组焦点小组讨论，并对数据进行了主题分析。结果：障碍涉及决策者特点、决策环境和研究系统三个方面，每个方面由相关主题和分主题构成；机构价值观、选择决策者的标准、对循证决策的态度是循证决策的重要障碍，并且与管理有关。结论：循证决策有不同层级的障碍，需要从多个角度寻找强化科学循证决策影响的解决方案；几个已经确定循证决策的障碍植根于卫生体系治理，如跨部门合作的薄弱、没有制定卫生研究重点。因此，为做好循证决策，加强卫生系统管理势在必行。 |
| 关键词:循证决策 利用 治理 决策 知识 伊朗 |
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| Strengthening evidence based decision making: is it possible without improving health system stewardship? |
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| Abstract:Background：Health systems worldwide have always suffered resource constraints. Therefore, making decisions informed by scientific evidence to optimize costs and prevent wastage of resources is both important and necessary. The current study was designed to identify barriers to evidence based decision making (EBDM) in Iran’s health system. Methods： Participants were purposively selected. In depth interviews with policy makers and focus group discussions (FGDs) with researchers were used to collect data.Thirteen in depth interviews and six FGDs were held. Data were analysed using thematic analysis. Results： The barriers mentioned were categorized into decision makers’ characteristics, the decision making environment and the research system, with each category consisting of further relevant themes and subthemes. Organizational values, criteria for selecting decision makers, and the attitude toward EBDM were found to be important barriers to EBDM, and were related to stewardship. Conclusion： There are various barriers to EBDM at different levels, and multi dimensional solutions are required to strengthen the impact of scientific evidence on decision making. Several recognized barriers to EBDM are rooted in health system stewardship, such as the weakness of inter sectoral collaborations and ill defined priorities. It appears that improvement of EBDM is secondary to the strengthening of health system stewardship. |
| Key words:Evidence based policy Utilization Governance Decision making Knowledge Iran |
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