Interventions to reduce the impact of dual practice in the public health sector

Dual practice (i.e. workers who work in the public and private sector) has an impact on health services in terms of quality and costs. However, the effectiveness of regulatory policies has not been proven.

We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

We identified three systematic reviews that included 23 primary studies overall, of which all correspond to observational studies. We concluded it is not clear whether the interventions to reduce the negative consequences of dual practice in the health system are effective because the certainty of the available evidence is very low.