Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 10, 2023
Date Accepted: Apr 14, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Obstacles to evidence-based procurement, implementation and evaluation of health and welfare technologies in municipalities: A mixed-methods study from Sweden.
ABSTRACT
Background:
Health and social care must be evidence-based according to national policy, but there are indications that evidence for health and welfare technology (HWT) effectiveness is lacking in related Swedish municipal work processes.
Objective:
To explore the use of evidence when Swedish municipalities procure, implement, and evaluate HWT, and what support municipalities desire regarding this.
Methods:
An explanatory sequential mixed-methods design employed quantitative surveys and subsequent semi-structured interviews of officials in five designated “model” municipalities regarding HWT use.
Results:
In the past 12 months, four of five municipalities had required some form of evidence during procurement processes, but the frequency of this was variable and often consisted of references from other municipalities. Two of five municipalities used an established process for implementation of HWT and three of five had a plan for structured follow-up, but the use and dissemination of evidence within these varied greatly. All municipalities desired or suggested support regarding evidence-based work with HWT, including establishing evaluation frameworks and qualitative follow-up of effectiveness.
Conclusions:
Structured use of evidence in procurement, implementation, and evaluation of HWT is inconsistent among municipalities, and internal and external dissemination of evidence for effectiveness is rare. This may establish a legacy of ineffective HWT in municipal settings. The results suggest that existing national agency guidance is not sufficient to meet current needs. New, more effective types of support to increase the use of evidence in critical phases of municipal procurement and implementation of HWT is recommended.
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