Costs and economic impact of student-led clinics-A systematic review.

IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Medical Education Pub Date : 2024-10-31 DOI:10.1111/medu.15550
Debra Mitchell, Stephen Maloney, Luke Robinson, Terry Haines, Jonathan Foo
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Abstract

Purpose: Student-led clinics generate a range of benefits to multiple stakeholder groups. Students receive important educational opportunities to advance in their training. Patients with limited access to care may access effective care or a higher amount of effective care and so reduce burden on the health care system. The financial viability of student-led clinics run by universities is uncertain, and establishing this is complicated by the range of stakeholder costs and benefits that may be involved. This systematic review aimed to synthesise evidence related to the costs and benefits of student-led clinics and report the methods that have been used to measure these costs and benefits.

Method: We conducted a systematic search of MEDLINE All, PsychInfo, CINAHL, A+ Education (Informit), ERIC (ProQuest) and ProQuest Education databases for studies that reported the costs and/or economic benefits of student-led clinics from inception through August 2023. Studies were screened for eligibility, and data were extracted including study characteristics, student-led clinic description and economic outcomes. A narrative synthesis was undertaken due to the heterogeneity of studies.

Results: Of 349 potentially eligible studies, 24 were included. Nine studies (38%) used an outcome description-monetised approach; four used partial economic evaluation (17%); four employed cost description (17%); two used cost approximation (8%); two used cost analyses (8%); and one was a full economic analysis (4%). Studies examined costs or benefits, from the perspective of a range of stakeholders, but few examined both. Only six studies (25%) had established the clinical effectiveness of their service. Student clinics generate costs for universities in supplying supervision, capital and consumables. Benefits are shared by patients, students, universities and the broader health system, however, economic evaluations to date have largely ignored or not monetised/valued these benefits.

Conclusions: Student-led clinics involve many different stakeholders, each of whom may incur costs and reap benefits. This complicates how we can go about trying to establish the economic efficiency and viability of student-led clinics. Measurement of both costs and benefits is needed to understand the efficiency of student-led clinics in comparison to alternatives. Without the full picture, decision-makers may make decisions that are ill-informed and lead to a loss of benefit for society.

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学生主导诊所的成本和经济影响--系统回顾。
目的:学生主导的诊所可为多个利益相关群体带来一系列好处。学生获得重要的教育机会,在培训中不断进步。获得医疗服务机会有限的患者可以获得有效的医疗服务或更多有效的医疗服务,从而减轻医疗系统的负担。由大学运营的学生主导诊所在财务上的可行性尚不确定,而且由于可能涉及到一系列利益相关者的成本和收益,确定其可行性也变得复杂。本系统性综述旨在综合与学生主导诊所的成本和收益相关的证据,并报告用于衡量这些成本和收益的方法:我们对 MEDLINE All、PsychInfo、CINAHL、A+ Education (Informit)、ERIC (ProQuest) 和 ProQuest Education 数据库进行了系统性检索,以查找从开始到 2023 年 8 月期间报告学生主导诊所的成本和/或经济效益的研究。我们筛选了符合条件的研究,并提取了包括研究特征、学生主导诊所描述和经济成果在内的数据。由于研究的异质性,我们进行了叙述性综合:在 349 项可能符合条件的研究中,有 24 项被纳入。九项研究(38%)采用了结果描述--单一化方法;四项研究采用了部分经济评估(17%);四项研究采用了成本描述(17%);两项研究采用了成本近似法(8%);两项研究采用了成本分析(8%);一项研究采用了全面经济分析(4%)。研究从一系列利益相关者的角度对成本或效益进行了审查,但很少有研究对两者都进行了审查。只有六项研究(25%)确定了其服务的临床效果。学生诊所在提供监督、资金和消耗品方面为大学带来成本。患者、学生、大学和更广泛的医疗系统共享收益,但迄今为止的经济评估大多忽视或未对这些收益进行货币化/估价:结论:学生主导的诊所涉及许多不同的利益相关者,每个利益相关者都可能产生成本并获得收益。这就使得我们如何确定学生主导型诊所的经济效益和可行性变得更加复杂。要了解学生领导的诊所与其他诊所相比的效率,就需要对成本和收益进行衡量。如果不能全面了解情况,决策者可能会做出不明智的决定,导致社会利益受损。
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来源期刊
Medical Education
Medical Education 医学-卫生保健
CiteScore
8.40
自引率
10.00%
发文量
279
审稿时长
4-8 weeks
期刊介绍: Medical Education seeks to be the pre-eminent journal in the field of education for health care professionals, and publishes material of the highest quality, reflecting world wide or provocative issues and perspectives. The journal welcomes high quality papers on all aspects of health professional education including; -undergraduate education -postgraduate training -continuing professional development -interprofessional education
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