Dossier n. 144/2007 [Abstract] The epidemiology of healthcare research in the Regional Health Service of Emilia-Romagna. Results of the first survey

The Law n. 29/2004 established the re-organisation of the Regional Health Service of Emilia Romagna region. The systematic introduction of “research” as key endeavour of the health service is one of the pivotal legislative innovation of the mentioned bill, and a multi-annual R&D program (called PRI E-R, Programma Ricerca e Innovazione Emilia-Romagna) was launched to accompany this initiative. To obtain a baseline picture of the epidemiology of health care research in the region, a survey was carried out to assess the type and amount of research activities undertaken in the regional health services between 2002 and 2004. Its results are presented in this report.

A total of 3,061 research projects were identified, nearly two thirds (59%) of which carried by Hospital Trusts. The most frequent types of investigations fell into one of the following categories: “evaluation of efficacy/effectiveness of diagnostic/therapeutic interventions” (39.9%), “observational studies” (13.1%) and “basic/pre-clinical research” (8.3%). More than half projects (53%) focused on the therapeutic area, followed by diagnostics (10%), preventative (7%) and rehabilitation (2%). Oncology was the most frequent discipline (22%) followed by cardiovascular diseases (12.6%), infectious diseases (7.8%), gastroenterology (7.8%) and haematological disorders (6.9%).

Among the evaluative projects, the most represented areas dealt with “improvement of healthcare quality and appropriateness” and “evaluation of organizational and healthcare models” (7.9% and 7.2%, respectively). Most projects had descriptive goals (71.4%) and only 21.6% were evaluative. Nearly half of the projects identified in the survey were

Less than half (40.5%) projects were fully o partially funded by pharmaceutical and biomedical industries, while public sources (national or regional) supported 47.5% projects (with approximately 30% represented by internal resources of the individual Local Health Unit/Trust).

The results of this first survey will inform the activities that are currently going on to build a research infrastructure in the Regional Health Service of Emilia-Romagna. The main findings from this study highlight the need of the following initiatives:

• development of healthcare research competences and facilitation of networking among Local Health Units and Trusts;
• integration between the regional health service’s R&D activities with academic research, with special reference to the Medical Schools based in the four teaching hospitals in the region;
• identification of priority areas for educational interventions to strengthen research skills and capacities, as well as facilitate the implementation of research networks;
• strengthening the relationships with the pharmaceutical and biomedical industry to identify areas where strategic collaboration can be improved;
• implementation of the infrastructure needed to set up a research capacity and to support research and innovation activities (i.e. prospective technology assessment) at regional level;
• setting up of a system to trace research activities (i.e. a prospective regional register), assessing both the direct (i.e scientific publications, development of careers, scientific training, etc.) and the broader outcome(s)/benefits of these activities (research capacity, absorption of the information produced, improvement of appropriateness and quality of care, organisational impact, influence on policy and product development).