Supporting Efficiency Improvement in Public Health Systems: a Rapid
Systematic Review of Current Evidence
AbstractRationale, aims and objectives Public health systems are under pressure
to meet increasing demand for health care in environments of increasing
financial resource constraint. There is therefore a need to maximise
health outcomes given limited public healthcare expenditure. This paper
aims to establish the extent of literature and approaches to efficiency
improvement in public health systems of developed countries. Methods The
Rapid Evidence Assessment model was used to address the review question.
Two database searches returned a result of 3,526 unique titles, which
were individually screened for potential relevance. 144 titles were
selected for full review to determine relevance. 73 papers were included
in the final review. Results Data on country, study design, key findings
and links to efficiency improvement were extracted and synthesized.
Synthesis of findings revealed that the literature on this topic is
disparate and non-cohesive. A range of isolated approaches were
described, and no evidence or consensus on a single best-practice
approach to efficiency improvement was identified. Conclusions Combining
the factors identified in this review has the potential to inform a
framework for supporting efficiency improvement in public health
systems. By considering these factors central health system management
bodies can support efficiency improvement to deliver both financial and
health services benefits.