Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Policy Making”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed2005

Maintaining an agenda for children: the role of data in linking policy, politics and outcomes.

There is growing recognition in Australia of the importance of early childhood to later health and wellbeing, with developments such as the National Agenda for Early Childhood and the National Public Health Action Plan for Children. To sustain a policy agenda for children and improve long-term outcomes, we need timely, comprehensive and accurate indicators and data on child health, development and wellbeing. Building this evidence requires a national monitoring and surveillance system that involves more than aggregating or linking existing data. Steps to building a national system are: to agree on key indicators of child health, development and wellbeing for regular reporting, to research a comprehensive set of indicators for each domain and ascertain data gaps, and to ensure development and coordination of data relevant to policy-making.

Australia↗
PubMed1983

Pluralism, professionalism and politics in nursing.

This paper describes the pluralist nature of the nursing society and highlights the different and often conflicting objectives of the several interest groups. In the second section the paper describes how the Royal College of Nursing dealt with these difficulties during the years 1948-61. The paper ends with a discussion of the present and future position in policy making with particular reference to the position of the Rcn as the nurses' professional organisation.

Education, Nursing↗
PubMed2004

Evidence for public health policy on inequalities: 1: the reality according to policymakers.

OBJECTIVE: To explore with UK and international policy advisors how research evidence influences public health policy making, and how its relevance and utility could be improved, with specific reference to the evidence on the production and reduction of health inequalities. DESIGN, SETTING, AND PARTICIPANTS: Qualitative residential workshop involving senior policy advisors with a substantive role in policy development across a range of sectors (mainly public health, but also including education, social welfare, and health services). In four in depth sessions, facilitated by the authors, focused questions were presented to participants. Their responses were then analysed thematically to identify key themes, relating to the availability and utility of existing evidence on health inequalities. MAIN RESULTS: The lack of an equity dimension in much aetiological and evaluative research was highlighted by participants. Much public health research was also felt to have weak underlying theoretical underpinnings. As well as evaluations of the effectiveness and cost-effectiveness of policy and other interventions, they identified a need for predictive research, and for methodological research to further develop methods for assessing the impact on health of clusters of interventions. CONCLUSIONS: This study reinforces the view that there is a lack of information on the effectiveness and cost-effectiveness of policies, and it uncovered additional gaps in the health inequalities evidence base. A companion paper discusses researchers' views of how the production of more relevant public health evidence can be stimulated.

Evidence-Based Medicine↗
PubMed2003

An evidence-based approach to the prevention of oral diseases.

The evidence-based approach has become the mantra of health care and service delivery. But just what it means, whether it is feasible, how to build it and the outcome of its use are not well understood. The aims of this paper are to provide an overview of an evidence-based approach to the prevention of oral disease, to examine the assessment of clinical trial evidence, to examine emerging approaches to assessing population-wide interventions and oral health promotion, and to illustrate some principles and issues through examples from preventive dentistry. The evidence-based approach to prevention is presented using an evidence loop, which emphasizes that the evidence-base should begin with an understanding to the burden of oral disease and its determinants, rather than a consideration of the efficacy or effectiveness of interventions in clinical dental research. A systematic review of evidence from clinical dental research is compiled and assessed, after which the intervention is decided upon and implemented. The evidence loop is completed by the monitoring of outcomes and reassessment of the intervention process. Attention is also given to steps in assessing non-randomized population-wide interventions and evidence on oral health promotion based on expert opinion. The requirement for evidence creates a substantial challenge which can only be met by increased research activity, improved quality of information and the appropriate application of the outcomes of research to policy making for the prevention of oral disease.

Cost of Illness↗
PubMedDate not supplied

The patient as a policy factor: a historical case study of the consumer/survivor movement in mental health.

This paper analyzes the history of the modern consumer/survivor movement and its impact on the policy-making climate in the mental health field. The growing attentiveness to consumers' perspectives is presented largely as a consequence, not a cause, of radical restructurings of the mental health system. Consumers' perspectives have entered policy discourse in the wake of policy failures and have flourished in a climate of perpetual crisis and tight budgets. Precisely because it has been such a contested arena for so long, the mental health field has produced some innovative responses to demands for patient empowerment.

Community Health Planning↗
PubMed2002

The role of oversight in the health sector: the example of sexual and reproductive health services in India.

This paper examines the role of oversight in influencing the health sector, using examples from sexual and reproductive health services in India. Rather than simply trying to provide services through traditional bureaucratic mechanisms, governments can make use of oversight tools to influence how health care is delivered through the public and private sectors. Three main oversight functions are described: understanding health system performance, deciding when to intervene in the health system and strategizing and implementing change. Governments also need to understand the ethical basis for decisions. The potential for administering oversight through policy-making, disclosing and informing, regulating, collaborating, and strategically subsidising and contracting services in sexual and reproductive health is described. This approach implies an engagement with a broader set of stakeholders in the health sector than is often the case. It requires a set of skills for public officials beyond managing public programmes, and relies on a larger role for other stakeholders and the general public. When applied to reproductive and sexual health, implementation of the full range of oversight functions offers new opportunities to provide more effective, equitable, accountable and affordable services.

Decision Making, Organizational↗
PubMed2003

Implementing health care reform in Israel: organizational response to perceived incentives.

Devising new incentives was a main element of health care reform in Israel, which created a regulated market that embodies many principles of managed competition. This study examined sick fund directors' perceptions of the new incentives and their strategic responses to these incentives, enabling the testing of how managed competition works in practice. The methodology used was a multiple case study of Israel's four sick funds. Data were gathered through in-depth interviews with 160 senior officials, analysis of national health insurance legislation, and analysis of published and unpublished archival documents, newspaper articles, public statements of senior managers, and other published data on the sick funds' behavior. The study revealed discrepancies between planned and perceived incentives and highlighted the effect of the latter on strategy formulation. Analysis of sick fund strategies showed that their responses to managed competition incentives deviated from theoretical expectations, compromising some of the objectives of the reform. The study also shows that contextual features account for the specific model of managed competition that was implemented and for the specific strategies employed by the sick funds. The study concludes by highlighting the need to build a process that will enable policy makers to consider local contextual factors when planning and implementing reform, involving health care providers in designing incentives, continuously monitoring processes and outcomes in the reformed system, and allowing for flexibility in policy making.

Attitude of Health Personnel↗
PubMed1999

Scientific uncertainty and the role of expert advice: the case of health checks for coronary heart disease prevention by general practitioners in the UK.

This paper examines some of the ways in which scientific evidence influenced the development of the policy for the payment of general practitioners for coronary heart disease (CHD) prevention in the UK, in particular the introduction of 'health checks'. The specific policy events which are examined are the 1990 and 1993 contracts for health promotion by general practitioners. Data for this paper were provided by oral history interviews with key informants including general practitioners, public health doctors, civil servants and academics. The study shows the way in which complex scientific evidence interacted with other, professional and political, factors to produce a policy for which there was variable scientific evidence. The relationship between science and policy was complicated and tortuous but two aspects were particularly salient, the way in which scientific uncertainty influenced the content of the policy and the contribution of expert advice to policy making. The existence of social and technical uncertainty about the effectiveness of health checks allowed different players to hold different views depending on their professional affiliation or other agendas. The mechanisms by which scientific advice was given to policy makers were primarily by medical civil servants and through informal contacts and networks. There was no independent systematic formal system to assess and disseminate scientific advice to policy makers, for instance by an expert committee. These factors in turn allowed policy makers to ignore or misinterpret scientific evidence according to other policy imperatives.

Coronary Disease↗
PubMed2002

Restoration, stewardship, environmental health, and policy: understanding stakeholders' perceptions.

In recent years there has been considerable interest in the health of humans and the environment, restoration of contaminated or otherwise degraded lands, and in long-term stewardship of public lands. Unfortunately, it is unclear whether governmental agencies and the public hold similar views about the meanings of these concepts, making policy decisions about restoration and stewardship difficult. In this paper, I explore how the public conceptualizes restoration and stewardship by examining the relative rating of several attributes of restoration, stewardship, environmental health, ecological health, environmental restoration, and ecological restoration. People were interviewed in Santa Fe, New Mexico, USA, near the Department of Energy's Los Alamos National Laboratory. The ratings of attributes of environmental health and ecological health reported in this paper can be used to understand how the public understands these concepts. The attributes rated most highly by the subjects were more similar to definitions in the scientific literature for these terms than they were to those used by the Department of Energy. For environmental health, the highest rating related to human sanitation, while for ecological health the highest rating was for maintaining functioning ecosystems. Reduction of exposure to hazardous substances was rated the second highest for both environmental and ecological health. The wise use of natural resources, preservation of natural resources, and hazardous waste site cleanup were rated the highest attributes of stewardship. These data suggest that both expert and nonexpert perceptions about restoration and stewardship should be incorporated into environmental management decisions.

Conservation of Natural Resources↗
PubMed2001

Factors affecting the utilization of systematic reviews. A study of public health decision makers.

OBJECTIVE: To determine the extent to which public health decision makers used five systematic reviews to make policy decisions, and to determine which characteristics predict their use. METHODS: This cross-sectional follow-up study of public health decision makers in Ontario collected primary data using a telephone survey and a short, self-administered organizational demographics questionnaire completed by the administrative assistant for each Medical Officer of Health. Independent variables included characteristics of the innovation, organization, environment, and individual. Data were entered into a computerized database developed specifically for this study, and multiple logistic regression analysis was conducted. RESULTS: The participation rate was very high, with 85% of public health units and 96% of available decision makers completing the survey. In addition, 63% of respondents stated they had used at least one of the systematic reviews in the previous 2 years to make a decision. The most important predictors of use were one's position, expecting to use a review in the future, and perceptions that the reviews were easy to use and that they overcame the barrier of limited critical appraisal skills. CONCLUSIONS: Utilization of the systematic reviews in Ontario was very high. The utilization rates found in this study were significantly higher than those reported in previous utilization studies. One's position was found to be the strongest predictor of use, identifying program managers and directors as the most appropriate audience for systematic reviews.

Cross-Sectional Studies↗
PubMed1997

Health policy versus industrial policy in the pharmaceutical sector: the case of Canada.

This paper analyses the trade-off between health policy and industrial policy objectives in the field of pharmaceuticals in the Canadian policy setting. In Canada pharmaceutical regulation is organized in two tiers. The federal government is responsible for the conduct of industrial policy for the pharmaceutical sector, including the patenting of new molecular entities, the registration and approval of pharmaceutical products, and the pricing of new products. At the province level, policy-makers are responsible for the reimbursement of the cost of medicines; the methodologies implemented for this purpose may be geared towards meeting the objective of cost containment within tight health budgets rather than addressing industrial policy objectives and, thereby, supporting the pharmaceutical industry. The reimbursement methodologies implemented may also be related with the strength of pharmaceutical presence in each province. The paper provides evidence from two such provinces, British Columbia and Ontario, and contrasts pharmaceutical policy-making at the provincial level with that at the federal level.

British Columbia↗
PubMed2002

[Healthy Cities projects in Europe].

The WHO Healthy Cities Project has been developed in Europe to place health high on the agenda of city decision-makers. It has promoted comprehensive local strategies for health and sustainable development. Cities endorse principles and strategies, establish project infrastructures, work on specific goals, products, changes, and outcomes, and invest in formal and informal networking and cooperation. Consistent research and development efforts are contributing towards a more evidence-based policy making and to the emergence of a framework to meet the demands of the new public health movement.

Europe↗
PubMed2006

The challenge of developing evidence-based genetics health care in practice.

Evidence-based genetics health care is the conscientious use of current best evidence in decision-making at the clinical, administrative and policy-making levels. As knowledge generated from genomics research is integrated into medical care, the needs for appropriate evidence become more complex. The challenges to evidence-based care include: a lack of policy-relevant evidence in the domains of basic, clinical and health services research (including ethical, legal and social issues); difficulties in translating knowledge into appropriate decisions and actions, particularly in relation to the capacity of audiences to interpret evidence; and competing perspectives on the nature of evidence in genetics and genomics. In meeting these challenges, lessons will be learnt which are likely to be relevant to emerging biotechnologies and health care development more generally.

Canada↗
PubMed2001

HCFA and the states: politics and intergovernmental leverage.

In this article, we seek to explain variations in the Health Care Financing Administration's (HCFA) relationship to state governments. After reviewing several alternative models of the policy-making process, we argue that the utility of each model depends on certain issue characteristics, especially salience and conflict. We further argue that HCFA's choice of intergovernmental tools, rooted in a political setting, depends on the same issue characteristics. We illustrate our arguments by examining HCFA's behavior during the Clinton administration and by focusing on four cases: HMO performance measurement, nursing home regulation, lead screening for children, and the Children's Health Insurance Program (CHIP).

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1984

Nursing: past trends, future policies.

This paper looks at five historical trends in the field of macro-policy making for nursing. From these it postulates that nursing is, now, a pluralist structure with three main interest groups. Each interest group has its own view of reality and therefore its own goals and strategies, some of which are in conflict with those of the other groups. Furthermore, the goals of the nursing groups are also in conflict with those of the government health department. The paper proposes a typology for nursing which takes account of these conflicts, helps to identify the areas of conflict and makes a proposal for the future structure which would help to achieve a more harmonious framework in the NHS.

Humans↗
PubMed1994

Current status of economic appraisal of health technology in the European Community: report of the network. The EC Network on the Methodology of Economic Appraisal of Health Technology.

The use of economic evaluation to assess the costs and consequences of health care technologies has steadily increased in recent years. However, little is known about the influence economic studies have on health care decision makers or policy at local and national level. This paper reports the results of a survey of economic evaluations in EC countries to identify the impact of the results on decision and policy making in health care. Health service researchers in 10 EC countries were identified and asked to participate in the survey. The researchers were asked to locate economic evaluations in their country and complete a standardised questionnaire for each study. The criteria for inclusion in the survey were first, the studies should have been started or reported since 1987, second, the evaluations should include a comparison of the cost and consequences of the technologies assessed and finally, the appraisals should include a comparison of alternative health care technologies or programmes. A total of 66 studies which met the survey criteria were reported. Of these, 27% were thought to have influenced health care decision makers or policy. The results suggested that method of dissemination, source of funding and purpose of the study may be important determinants of whether an economic evaluation will be used in health care policy or decision making. The results of the survey suggest that economic evaluation currently has a relatively low impact on health care policy or decision making.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed2004

Health technology assessment and its influence on health-care priority setting.

In this article, we review the development of health technology assessment (HTA) in England and Wales, France, The Netherlands, and Sweden, and we summarize the reaction to these developments from a variety of different disciplinary and stakeholder perspectives (political science, sociology, economics, ethics, public health, general practice, clinical medicine, patients, and the pharmaceutical industry). We conclude that translating HTA into policy is a highly complex business and that, despite the growth of HTA over the past two decades, its influence on policy making, and its perceived relevance for people from a broad range of different perspectives, remains marginal.

Europe↗
PubMed2002

The World Health Report 2000: World Health Organization health policy steering off course-changed values, poor evidence, and lack of accountability.

The World Health Report 2000 on health systems has raised concerns about its political biases, its methods and indicators, and its lack of reliable data. Tracing the origins of the Report, this article argues that it counteracts many of the concerns that gave rise to preparation of the Report in the first place. The mutually agreed-upon value-base, expressed in the Health for All strategy, has been largely abandoned. The Report includes contradictory messages, and many of its recommendations are not evidence-based. Furthermore, the ranking of countries according to their health systems' performance is not useful for health-policy-making, even if the methods and data could be improved. Because the member states and governing bodies of the WHO were not consulted during the production of the Report, the WHO secretariat has not received a mandate to change the value-base of the WHO's health policy or the aims of the Report. The WHO should return to its mandate as a normative intergovernmental U.N. agency on health.

Communicable Disease Control↗