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Supporting Efficiency Improvement in Public Health Systems: a Rapid Systematic Review of Current Evidence
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  • James Walters,
  • Reema Harrison,
  • Anurag Sharma,
  • Emma Malica
James Walters
NSW Health
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Reema Harrison
University of New South Wales
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Anurag Sharma
University of New South Wales
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Emma Malica
NSW Health
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Peer review status:POSTED

14 May 2020Submitted to Journal of Evaluation in Clinical Practice
14 May 2020Assigned to Editor
14 May 2020Submission Checks Completed

Abstract

Rationale, 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.