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Exploring the Societal Returns of Research Conducted within Hospitals

Exploring the Societal Returns of Research Conducted within Hospitals New Frontiers in Evaluation Conference Vienna 2006, April 24th - 25th. Antonio García Romero and Luis Royuela Morales Agencia Laín Entralgo. Consejería de Sanidad y Consumo de la Comunidad de Madrid. Presentation Outline.

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Exploring the Societal Returns of Research Conducted within Hospitals

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  1. Exploring the Societal Returns of Research Conducted within Hospitals New Frontiers in Evaluation Conference Vienna 2006, April 24th - 25th Antonio García Romero and Luis Royuela Morales Agencia Laín Entralgo. Consejería de Sanidad y Consumo de la Comunidad de Madrid.

  2. Presentation Outline • Introduction • Framework • The study • Results • Conclusions

  3. Introduction • How much to spend on medical research? • It could be useful to measure the societal impacts of medical research • Difficult but Necessary • Difficult: we have a limited understanding of how research induce societal effects • Necessary: • In US: $70 billion / year saved in medical care costs • $90 billion / year sales of products unrelated to health care resulted from NIH R&D • Silverstein S. 1995

  4. 2. Framework The evaluation of scientific research based mainly bibliometrics and expert judgement (peer review). These methods are not very useful if the objective is to measure the returns from research in terms of wealth, employment or health. Development of new indicators and methods are needed

  5. Health Care (hospitals) HEALTH Life style decisions Environmental Conditions Genetics 2. Framework Statement 1: Improved health is a consequence of several factors and health care quality is only one of them

  6. Research Health Care Drugs / Health Technologies Training 2. Framework Statement 2: Health care is a result of the interaction of several factors such as research, training, health technologies and other organizational characteristics

  7. Clinical practice improvement Drugs innovation Health Tech. Innovation Research within hospitals Human Capital Other 2. Framework Statement 3: The research conducted within hospitals generates several societal outcomes, in addition to health care

  8. 2. Framework Statement 4: The relationship between medical research and its societal outcomes is very complex Lewison, G From Biomedical Research to Health Improvement, Scientometrics. 54(2): 179-92.

  9. 2. Framework • A consequence of this complexity is the existence of a wide set of methodological approaches that can be applied to analyze this topic • Macro approaches • Useful to estimate aggregated effects on employment, wealth or population’s health • Meso & Micro approaches • Useful to estimate direct / indirect effects, policy analysis, comparative analysis

  10. 2. Framework • A) The Region of Madrid • 6 mill. Habitants • 26.000 € GDP/percapita • B) The Public Health Care System of Madrid (SMS) • 24 + 8 hospitals • + 200 Primary Care Centers • Around 10,000 physicians • 2006 Budget: 6,066 mill. € • C) Research in SMS • 1,650 researchers (INE) • 13% of their time • 2,000 papers SCI / year

  11. 3. The Study • Objective: To analyze the effect that physicians’ research has on their clinical performance • Two Assumptions: • Research within hospitals should generate both scientific and societal returns • research allows physicians to improve their skills and knowledge level. • Methodology: • Individual data (micro approach) • Motivation, Satisfaction and Group Structure as explanatory variables • Structural Equation Modeling

  12. Motivation Ph.D Positive (+) Negative (-) (0: no Ph.D 1: Ph.D) Positive (+) SCI Impact Negative (-) (0: Men 1: Women) Positive (+) Positive (+) Positive (+) Positive (+) Gender Group Structure Positive (+) Satisfaction (*) 3. The Study Baseline model: Comprises two sets of hypotheses

  13. 3. The Study Data 279 physicians-scientists working in hospitals of SMS (Madrid)

  14. 3. The Study Variables: 3 observed variables & 4 constructs • We have estimated three models • Satisfaction with professionalcareer • Satisfaction with job climate • Satisfaction with scientific issues

  15. 4. Results

  16. Motivation Ph.D 0.21 0.30 -0.24 0.14 SCI Impact -0.17 0.20 0.64 Gender Group Structure SAT_CLI 4. Results

  17. 5. Conclusions Motivation and Job Satisfaction have a significant and positive effect on the perceived impact of research activity on clinical performance There is a significant relationship between Research Productivity and gender, academic degree, Motivation and Group structure These results suggest the strategic value of the human factor within R&D management

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