Integrative review; identifying the evidence base for policymaking and analysis in health care

Aim The aim of this was to identify and synthesize the evidence underpinning the health policymaking process to inform the development of a health‐related policy analysis framework. Design A mixed methods review using “Best Fit” Framework synthesis. Data Sources PUBMED and CINAHL+ databases for English language papers published between March 2013 – March 2017. Review Methods Titles were screened, data ed and analysed by two authors at each stage. Findings from included studies were coded against six a priori categories which had been constructed through a preliminary literature review, consultation and consensus. Results Sixty‐eight papers were included. There exists empirical support for six key domains which require to be addressed in the policymaking and analysis process: (1) Context; (2) Process; (3) Content; (4) Stakeholder Consultation; (5) Implementation; and (6) Evaluation. Failure to contextualize and integrate these six domains in problem identification, policy analysis, strategy and policy development, policy enactment and policy implementation is problematic. Conclusion There is a need to test and refine the constructs linked to the policymaking cycle taking cognizance of the context where these are developed, implemented and evaluated. Impact This review makes a novel contribution to the synthesis of evidence to inform the policymaking and analysis process. Findings illuminate the complexity of policymaking, the competing pressures involved and the importance of the local, national and international context. These findings have international relevance and provide empirical support for key criteria to guide those involved in context specific policymaking and/or the analysis of existing policy. 目的 本次研究的目的是确定并总结支持医护服务政策制定进程的证据,为制定医护服务相关政策分析框架提供信息。 设计 使用“最佳匹配”框架总结的混合方法评价。 资料来源 PUBMED和CINAHL+数据库所收录的2013年3月至2017年3月期间发表的英文论文。 综述方法 每一阶段由两位作者进行标题筛选、数据提炼和分析。对于所纳入研究的调查结果,按六个先验类别进行编码,这六个类别是在初步文献评价、咨询与共识基础上构建的。 结果 共纳入论文68篇。在政策制定和分析过程中有六个关键领域需要得到实证支持:(1)环境;(2)工艺;(3)内容;(4)利益攸关方咨询;(5)实施;(6)评价。在确定问题、政策分析、战略与政策制定、政策颁布和政策执行方面,未能将这六个领域联系起来并加以整合,这是会产生问题的。 结论 需要测试并完善政策制定周期相关的结构,同时,考虑这些结构的制定、实施和评估环境。 影响 本次评价对证据的总结作出了新的贡献,从而为政策制定和分析进程提供了依据。调查结果表明了政策制定的复杂性、所涉及的竞争压力以及地方、国家和国际环境的重要性。这些调查结果具有国际相关性,并为关键标准提供了经验支持,从而为那些参与到具体环境政策制定和(或)现有政策分析的人士提供指导。