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.
Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.