Originales
Prioridades de investigación en servicios sanitarios en el Sistema Nacional de Salud. Una aproximación por consenso de expertos
Setting health services research priorities in the public health system. An approach through expert consensus
Enrique Bernal-Delgadoa,
, Salvador Peirób, Rafael Sotocaa
Autor para correspondencia
ebernal.iacs@aragon.es
Correspondencia: Dr. Enrique Bernal-Delgado. Instituto Aragonés de Ciencias de la Salud. Avda. Gómez Laguna, 25. 50009 Zaragoza. España.
Correspondencia: Dr. Enrique Bernal-Delgado. Instituto Aragonés de Ciencias de la Salud. Avda. Gómez Laguna, 25. 50009 Zaragoza. España.
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Una aproximación por consenso de expertos" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "287" "paginaFinal" => "294" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Enrique Bernal-Delgado, Salvador Peiró, Rafael Sotoca" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Enrique" "apellidos" => "Bernal-Delgado" "email" => array:1 [ 0 => "ebernal.iacs@aragon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Salvador" "apellidos" => "Peiró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Rafael" "apellidos" => "Sotoca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Instituto Aragonés de Ciencias de la Salud, Red de investigación cooperativa en Epidemiología y Salud Pública (RCESP), Zaragoza, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Escuela Valenciana de Estudios de la Salud, Red de investigación cooperativa en Epidemiología y Salud Pública (RCESP), Valencia, España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. Enrique Bernal-Delgado. Instituto Aragonés de Ciencias de la Salud. Avda. Gómez Laguna, 25. 50009 Zaragoza. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Setting health services research priorities in the public health system. An approach through expert consensus" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-08-22" "fechaAceptado" => "2006-01-24" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13888" "palabras" => array:4 [ 0 => "Investigación en servicios de salud" 1 => "Prioridades en salud" 2 => "Apoyo a la investigación" 3 => "Consenso" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13887" "palabras" => array:4 [ 0 => "Health Services Research" 1 => "Health Priorities" 2 => "Research Support" 3 => "Consensus" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Identificar y priorizar los temas de investigación en los servicios sanitarios, adoptando una perspectiva orientada a satisfacer las necesidades de la población cubierta por el Sistema Nacional de Salud.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p class="elsevierStyleSimplePara elsevierViewall">Reunión de 13 expertos estructurada con una técnica grupal mixta, desarrollada en 2 fases consecutivas: grupo nominal y método Delphi. Se identificaron prioridades de investigación en servicios de salud que fueron puntuadas de la siguiente manera: de 7 a 9, muy relevante; de 4 a 6, relevancia intermedia, y de 1 a 3, poco o nada relevante. Los resultados fueron ordenados en función de su puntuación mediana y su dispersión.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se identificaron 53 temas de investigación. Se clasificaron como prioritarios los temas relacionados con estrategias para mejorar la efectividad de la atención sanitaria, la información a los pacientes, la calidad y la seguridad de la atención, la equidad y la accesibilidad de los servicios, y la sostenibilidad del sistema sanitario. El consenso entre estos temas fue muy alto: sólo 4 ítems obtuvieron una dispersión reseñable (intervalo intercuartílico [IQ]<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2). En un rango de prioridad intermedia se situaron los temas relacionados con las mejoras organizativas del sistema, las mejoras en productividad y eficiencia, y los recursos humanos y equipamientos. El disenso en este caso fue muy alto: el 59% de los ítems obtuvo un IQ<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Aún con diversas limitaciones, se ofrece una referencia de prioridades para los investigadores españoles en servicios de salud y, también, una referencia para los financiadores y los usuarios de esta modalidad de investigación.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of the present paper was to identify and prioritise health services research issues, from the perspective of Spanish NHS enrollees’ health needs.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">13 experts attended to a structured consensual meeting by using a two-phase process, sharing both Nominal Group and Delphi Technique features. Health Services Research Priorities were identified and scored (7 to 9, high relevance; 4 to 6 mild relevance and 1 to 3, low or no relevance). Results were sorted regarding the median score and its dispersion.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">53 research issues were identified. Strategies to improve effectiveness in health care, information to patients, health care quality and safety, equity, access and sustainability were considered of high priority and high consensus; just 4 items had remarkable dispersion (Intercuartile interval [ICI]<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2). Organizational improvement, productivity and efficiency enhancement, workforce and equipments were classified of mild priority. Additionally, this group of items reached very low consensus: 59% of them reached ICI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Our approach offers reference about priorities to Spanish health services researchers, and also, orientation to financers and users of this kind of research, though several limitations have been described.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13091144
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