Evidence map›Paper›PMID 40623738›Full record

ArticleBMJ open2025

Definition and key concepts of high-performing health systems: a scoping review.

Veronica Cho, Joslyn Trowbridge, Tyrone Perreira, Sundeep Sodhi, Alia Karsan, Hazim Hassan, Laure Perrier, Melissa Prokopy, Anthony Dale, Adalsteinn Brown

Abstract readScoping Review
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Veronica ChoOntario Hospital Association, Toronto, Ontario, Canada.
Joslyn TrowbridgeOntario Hospital Association, Toronto, Ontario, Canada.
Tyrone PerreiraOntario Hospital Association, Toronto, Ontario, Canada.
Sundeep SodhiOntario Hospital Association, Toronto, Ontario, Canada ssodhi@oha.com.ORCID http://orcid.org/0000-0001-5220-2171
Alia KarsanOntario Hospital Association, Toronto, Ontario, Canada.
Hazim HassanOntario Hospital Association, Toronto, Ontario, Canada.
Laure PerrierOntario Hospital Association, Toronto, Ontario, Canada.
Melissa ProkopyOntario Hospital Association, Toronto, Ontario, Canada.
Anthony DaleOntario Hospital Association, Toronto, Ontario, Canada.
Adalsteinn BrownDalla Lana School of Public Health University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine how high performing is defined in relation to a health system and chart the literature on the definitions and key concepts of high-performing healthcare systems.

designScoping review. DATA SOURCES: MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials were searched from inception to July 2024. The grey literature was also searched. ELIGIBILITY CRITERIA: Included studies reported on health systems and high performance to identify explicit definitions, research outcomes and knowledge gaps.

resultsTwo reviewers independently screened 5721 citations and 507 full-text articles, resulting in the inclusion of 35 primary articles and 47 companion documents in the review. Three independent definitions for a high-performance health system were identified. 24 research studies reported outcomes on the elements of a high-performing health system (58%), system evaluation (32%) and tool development or validation (10%). Knowledge gaps identified were the lack of a common definition, a lack of common indicators, strategies for moving evidence into policy and practice, and difficulties with comparisons across health systems.

conclusionsWe found limited definitions and a lack of empirical evidence on our topic. There is an opportunity for primary research in the area of health systems and high performance.

Indexed as

Delivery of Health CareQuality of Health CareHumansDelivery of Health Care, IntegratedHealth ServicesHEALTH SERVICES ADMINISTRATION & MANAGEMENT

Identifiers

PMID40623738
PMCPMC12230970

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.