2015年为有趣的内容带来了BMC Health Services Researchincluding the articles that featured in the cross journal collection“医疗保健质量的许多含义”。现在，2016年与我们同在，我们想借此机会反思过去12个月发布的一些亮点。

Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study

Chronic conditions and multimorbidity represent major concerns in global healthcare yet data on the pressures these place on health infrastructure is limited. In this study, Bahler and colleagues examine the association of multimorbidity, health care utilization and costs in the Swiss community-dwelling population. They report the high prevalence of multimorbidity in the study population and indicate the stark difference in the mean number of consultations in the mulitmorbid compared the non-mulitmorbid sample. The study highlights marked differences in costs in the multimorbid patients and indicates that multimorbid patients were significantly more likely to be hospitalized. Quantified data on the burden of multimorbidity are essential to improving the management of patients and decision-making in resource allocation.

确定医疗保健中创新实施的预测因素：实施有效性的定量分析

Complex innovations offer great promise in healthcare organizations with potential benefits for patients and physicians alike. Jacobs and colleagues quantitatively examined innovation implementation framework among participants in the Nation Cancer Institute’s Community Clinical Oncology Program using structural equation modeling. They found that perceptions of the implementation climate have a direct effect on the effectiveness of the process. Physician’s perceptions of the implementation climate had an influence on implementation policies practice and enrollment. The findings of this study support the recommendation that managers looking to improve implementation effectiveness should create an environment perceived as encouraging implementation with specific expectations, support and rewards for use.

Roundtable discussion on the Third Global Symposium on Health Systems Research: why prioritize talk over aid in the midst of the Ebola crisis?

Sharing our collective knowledge about a broad array of health system concerns may provide the innovation and impetus to accelerate the improvement of those systems worldwide. At the Third Global Symposium on Health Systems Research in late 2014, experts from around the world were challenged to discuss the benefits of their attendance and participation in the event. In the midst of the Ebola crisis, Lazarus and colleagues highlighted the need to meet and discuss a broad range of health systems issues and explained why they should be prioritized at a time when resources were urgently needed to address an acute health crisis. This correspondence article discusses a number of important concerns including the neglect of health systems, the motivation of health workers and reproductive health in the face of the Ebola epidemic.

照顾患者，照顾记录：对“后台”工作的民族志研究，以维护一般的护理质量

患者记录中包含的信息在提高患者护理的质量，安全性和效率方面起着重要作用。在这项研究中，Swinglehurst和Greenhalgh探索了总结和编码记录的工作，并确定了这些程序对护理质量的障碍。该研究使用人种学观察方法作为英国医学研究委员会资助的组织研究中医疗电子记录的一部分。调查结果表明，编码工作可能是一项耗时的企业，通常会经常共享或委派给行政人员，并提倡建立新的问责制的要求。

National health research system in Malawi: dead, moribund, tepid or flourishing?
Strengthening health research systems in the World Health Organization’s African Region by improving the capacity of individuals and institutions to generate scientific knowledge is widely acknowledged as an important step in achieving the goal of universal health coverage. In this debate article, Kirigia and colleagues discuss the extent to which Malawi has taken up this challenge and the necessary steps required to meet this objective. They highlight that Malawi (like several other African countries) need to invest more in improving governance, developing and sustaining resources, financing research and using research findings in policy development and public practice.