Hospital contextual factors affecting the implementation of health technologies: a systematic review

BMC Health Services Research

Chiara de Waure¹  Irene Gabutti²  Americo Cicchetti²  Adriano Grossi³  Ilda Hoxhaj³  Maria Lucia Specchia⁴  Stefania Boccia⁵ 

[1] Department of Medicine and Surgery, University of Perugia, Perugia, Italy;Graduate School of Health Economics and Management (ALTEMS), Faculty of Economics, Università Cattolica del Sacro Cuore, Rome, Italy;Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy;Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy;Clinical Governance Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy;Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;

关键词: Technology;    Implementation;    Hospital;    Systematic review;    Health technology assessment;   

DOI  :  10.1186/s12913-021-06423-2

来源: Springer

【 摘 要 】

BackgroundTo keep a high quality of assistance it is important for hospitals to invest in health technologies (HTs) that have the potential of improving health outcomes. Even though guidance exists on how HTs should be introduced, used and dismissed, there is a surprising gap in literature concerning the awareness of hospitals in the actual utilization of HTs.MethodsWe performed a systematic literature review of qualitative and quantitative studies aimed at investigating hospital contextual factors that influence the actual utilization of HTs. PubMed, Scopus, Web of Science, Econlit and Ovid Medline electronic databases were searched to retrieve articles published in English and Italian from January 2000 to January 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies, Newcastle-Ottawa Scale for the cross-sectional studies and the Mixed Methods Appraisal Tool for mixed method studies.ResultsWe included 33 articles, which were of moderate to high methodological quality. The included articles mostly addressed the contextual factors that impact the implementation of information and communication technologies (ICTs). Overall, for all HTs, the hospital contextual factors were part of four categories: hospital infrastructure, human resource management, financial resources and leadership styles.ConclusionOur systematic review reported that the contextual factors influencing the HTs utilization at hospital level are mainly explored for ICTs. Several factors should be considered when planning the implementation of a new HTs at hospital level. A potential publication bias might be present in our work, since we included articles published only in English and Italian Language, from January 2000 to January 2019. There remains a gap in the literature on the facilitators and barriers influencing the implementation and concrete utilization of medical and surgical HTs, suggesting the need for further studies for a better understanding.

【 授权许可】

CC BY