Evidence Use in Decision-making in Hospital Organizations: A Systematic Review Across Regional and Global Contexts
1
1 Programa de Pós-graduação em Administração (PPGAdm), Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
2
2 Departamento de Patologia, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1875
ABSTRACT
INTRODUCTION:
The use of scientific evidence in organizational decision-making is promoted as a strategy to improve quality, efficiency, and equity in health systems. Hospitals play a central role; however, evidence use in hospital decision-making remains uneven across regional and socioeconomic contexts. This systematic review examines how evidence is used in decision-making processes within hospital organizations, comparing experiences from Latin America with global contexts.
METHODS:
A systematic literature review was conducted using the Web of Science and Scopus databases, including articles published in the past five years and available in English, Spanish, and Portuguese. Search strategies combined terms related to evidence-based management, evidence-informed decision-making and hospital organizations. Records were merged and deduplicated using RStudio. After title and abstract screening, full-text articles aligned with the study scope were included. Articles were analyzed thematically, focusing on decision-making levels, types of evidence used, and organizational barriers and facilitators across regional and global contexts.
RESULTS:
The review identified a limited but growing body of literature on evidence use in hospital decision-making. Evidence use was shaped by organizational culture, leadership support, professional hierarchies, and institutional capacity. In Latin America, structural constraints, limited resources, and fragmented information systems were prominent barriers, while university hospitals and public health institutions supported evidence uptake. Globally, similar challenges were observed, although hospitals in high-income settings reported better access to data infrastructure and decision-support mechanisms. Across contexts, managerial decisions relied more often on experiential and contextual knowledge than on formal research evidence.
CONCLUSIONS:
Evidence use in hospital decision-making reflects organizational and contextual conditions that reproduce inequalities across health systems. By examining how hospitals integrate different forms of evidence across contexts, this review contributes to understanding equity and sustainability in decision-making. Strengthening context-sensitive strategies for evidence-informed decision-making in hospital organizations may support more equitable and sustainable health systems.
The use of scientific evidence in organizational decision-making is promoted as a strategy to improve quality, efficiency, and equity in health systems. Hospitals play a central role; however, evidence use in hospital decision-making remains uneven across regional and socioeconomic contexts. This systematic review examines how evidence is used in decision-making processes within hospital organizations, comparing experiences from Latin America with global contexts.
METHODS:
A systematic literature review was conducted using the Web of Science and Scopus databases, including articles published in the past five years and available in English, Spanish, and Portuguese. Search strategies combined terms related to evidence-based management, evidence-informed decision-making and hospital organizations. Records were merged and deduplicated using RStudio. After title and abstract screening, full-text articles aligned with the study scope were included. Articles were analyzed thematically, focusing on decision-making levels, types of evidence used, and organizational barriers and facilitators across regional and global contexts.
RESULTS:
The review identified a limited but growing body of literature on evidence use in hospital decision-making. Evidence use was shaped by organizational culture, leadership support, professional hierarchies, and institutional capacity. In Latin America, structural constraints, limited resources, and fragmented information systems were prominent barriers, while university hospitals and public health institutions supported evidence uptake. Globally, similar challenges were observed, although hospitals in high-income settings reported better access to data infrastructure and decision-support mechanisms. Across contexts, managerial decisions relied more often on experiential and contextual knowledge than on formal research evidence.
CONCLUSIONS:
Evidence use in hospital decision-making reflects organizational and contextual conditions that reproduce inequalities across health systems. By examining how hospitals integrate different forms of evidence across contexts, this review contributes to understanding equity and sustainability in decision-making. Strengthening context-sensitive strategies for evidence-informed decision-making in hospital organizations may support more equitable and sustainable health systems.
| eISSN: | 2654-1459 |
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