With vigorous development of the Evidence-Based Practice (EBP), systematic review as a reliable basis for decision making is becoming more and more important, especially in emergent and significant situation under the influence of various interferences. But there are many misunderstandings and fallacies in systematic review beyond medical field, which block the spread and application of systematic review in health system decisions. This paper takes the evidences of health intervention practice as examples, explores the functions of systematic review in health system decisions, tries to clarify these misunderstandings and fallacies, and so as to promote the development of systematic review.
An increasing number of health system researchers use systematic review to synthesize research evidence to inform the development of health policies at global and national levels. However, there are methodological challenges facing the health system research in undertaking systematic reviews of health policy literatures. This paper explored the constraints and promise of systematic review as a tool for evidence-based health system research in developing countries. It introduced the systematic review method and its evolution in health research over the past decades. The paper then discussed the definition of health system research, as system science, and contrasted its features/characteristics to those of medical research. It discussed and analyzed if the systematic review could be an effective tool for evidence-based health system research, particularly in developing countries. The paper concludes that the systematic review may be a very useful tool that can be used for evidence-based health system research to address specific policy issues; however, research on some health system/policy issues may not be appropriate to use the systematic review at all.
With the continuous development of health system, more and more countries recognize that the health system performance evaluation is an indispensable part of improving government management and health system. Some developed countries have already set up comparatively perfect evaluation systems. This paper compared and deeply analyzed the history of establishment, evaluation framework, evaluation index, and evaluation data of the health system performance evaluation systems of Britain, Australia and the United State, and some suggestions for improving the evaluation of new medical reform in China were given.