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Alternative service models for delivery of healthcare services in high-income countries: a scoping review of systematic reviews
  1. Rebecca L Jessup1,2,3,
  2. Denise A O’Connor1,2,
  3. Polina Putrik1,2,
  4. Kobi Rischin1,2,
  5. Janet Nezon2,
  6. Sheila Cyril1,2,
  7. Sasha Shepperd4,
  8. Rachelle Buchbinder1,2
  1. 1 Monash Department of Clinical Epidemiology, Cabrini Institute, Monash University, Malvern, Victoria, Australia
  2. 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. 3 Department of Allied Health, Northern Health, Melbourne, Victoria, Australia
  4. 4 Nuffield Department of Population Health, University of Oxford, Oxford, UK
  1. Correspondence to Dr Rebecca L Jessup; rebecca.jessup{at}


Introduction Costs associated with the delivery of healthcare services are growing at an unsustainable rate. There is a need for health systems and healthcare providers to consider the economic impacts of the service models they deliver and to determine if alternative models may lead to improved efficiencies without compromising quality of care. The aim of this protocol is to describe a scoping review of the extent, range and nature of available synthesised research on alternative delivery arrangements for health systems relevant to high-income countries published in the last 5 years.

Design We will perform a scoping review of systematic reviews of trials and economic studies of alternative delivery arrangements for health systems relevant to high-income countries published on ‘Pretty Darn Quick’ (PDQ)-Evidence between 1 January 2012 and 20 September 2017. All English language systematic reviews will be included. The Cochrane Effective Practice and Organisation of Care taxonomy of health system interventions will be used to categorise delivery arrangements according to: how and when care is delivered, where care is provided and changes to the healthcare environment, who provides care and how the healthcare workforce is managed, co-ordination of care and management of care processes and information and communication technology systems. This work is part of a 5-year Partnership Centre for Health System Sustainability aiming to investigate and create interventions to improve health-system-performance sustainability.

Ethics and dissemination No primary data will be collected, so ethical approval is not required. The study findings will be published and presented at relevant conferences.

  • healthcare delivery
  • sustainability
  • alternative healthcare models
  • delivery arrangement
  • high-income
  • scoping review

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  • RLJ and DAO’C contributed equally.

  • Contributors The study conception and overall design was conceived by RB and DAO. RLJ, DAO and PP designed the data extraction tool and RLJ, PP, KR and JN all assisted in piloting. RLJ wrote the first draft of this protocol and RB, DAO, PP, KR, JN, SC and SS critically reviewed the manuscript, contributed improvements and approved the final version.

  • Funding This work was supported by an NHMRC Partnership Centre for Health System Sustainability (Grant ID: 9100002). Along with the NHMRC, the funding partners in this research collaboration are: BUPA Health Foundation; NSW Health; Department of Health, Western Australia; and The University of Notre Dame Australia. RB is funded by an NHMRC Senior Principal Research Fellowship (#APP1082138).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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