There is significant amount of hospital based research with loads of biomedical research institutes. I am curious to know if there is evidence showing the benefits of hospital based research to the health of populations, training of health workers and clinical care (the easy bit).
Hmm....no takers so far? I would really appreciate your answers/feedback.
It would depend on the health problem/issue which is focus of research. I believe your question is too broad. I hope the hospital based research improves the effectiveness of treatment and ideally should be a part of the overall care.
Thank you. I am interested in evidence for all areas but will be happy for examples related to infectious diseases-adult or paediatrics.
My experience is mainly in Psychiatry. I see the system of care a continuum between community and hospital. I cannot see the community system functioning effectively without hospital component hence any hospital based research is relevant to the health of population. Similarly I can imagine research done on hospital interventions in heart disease (for example angioplasty) will be relevant to health of population. One can always argue about benefits of health life style and why go to the stage where you need angioplasty.
I agree with what you have said. This is really what we as clinicians expect despite our 'one individual at a time approach' to health. Interestingly, I cannot seem to find published evidence of the impact of hospital based research on public or population health.
From a low income setting I feel the great focus of programme and research spending is primarily on the community. In fact I'd go so far as to suggest there is a complete obsession with community-based projects, with the understandable desire of coming up with scalable solutions to some of the big public health problems. However, at the centre of any decent health system you need a competent and well-resourced centre of excellence (or multiple such centres) from which expertise can filter down into the community. Sadly, many referral centres in the developing world do not fit this description, surely in part due to funder obsession with serving the community. Hospitals ARE part of the community, and i fear in many cases are 'transmission centres' for drug resistant TB and multi drug resistant bacteria. I have not systematically reviewed this, as you say it is such a broad issue and not my area of expertise, but someone should.
The advantage of hospital-based research is that the technical manpower & laboratory facilities are available to diagnose Illness and do research at hospitals . Regarding Infectious diseases , symptomatic ( mild & severe ) patients can be evaluated & treated in hospitals only . The Incidence data of any Infectious disease can be easily obtained from hospitals . The prevalence data can be designed for community , by utilizing the hospital data . Most of research publications on severe Infectious data come from hospitals only .
My personal experience on human leptospirosis in India is based on hospital data only . The primary reason being availability of clinical material & laboratory facilities to diagnose the disease in hospital . This is relevant for developing countries , where there is shortage of skilled manpower & finance to do community based research . It was possible for me to design guidelines for diagnosis & management of leptospirosis , based on my hospital experience for community practice also.
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