Building research infrastructure across a health service

Hanney discusses the reasons for building research infrastructure widely across a health service. In England, National Health Service hospitals in the cancer research network that participated in colorectal cancer trials had lower mortality rates from colorectal cancer than other hospitals, after adjusting for case mix and hospital-level variables. This trend was not restricted to academic centres or large hospitals, but there was a dose effect. The effect of research engagement on health care performance, though, is not unique to England or to research networks. A review of global literature on research engagement by health care providers found that North America provided the majority of studies reporting improved health care performance associated with clinicians or health care organizations that were active in research.