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Results for “Policy Making”

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At least 127 records · Page 7Linked to original sources
PubMed2003

The unbearable lightness of healthcare policy making: a description of a process aimed at giving it some weight.

OBJECTIVES: To investigate whether a structured process to involve policy makers in designing a research project on a return to work insurance policy would yield evidence that was relevant, useful, and used in policy decisions. STUDY DESIGN: Case study. SETTING: Norway. PARTICIPANTS: Two researchers from the National Institute of Public Health and four representatives from respectively the National Insurance Administration, Norwegian Confederation of Trade Unions, Confederation of Norwegian Business and Industry, and Norwegian Medical Association. INTERVENTION: Structured discussions of the research, including the objectives, interventions, design, and interpretation of the results. RESULTS: The participants succeeded in designing and completing a cluster randomised controlled trial through the participatory process. Intermediary results from the trial have been used in practical planning within the National Insurance Administration, but there are few indications that the main results of the trial have been used. CONCLUSIONS: This approach of involving policy makers in the research planning process when political or organisational values are at stake did not succeed in this case. The salient explanations for this are conflicting interests of the organisations involved in the process and the research findings were in conflict with those interests.

Attitude of Health Personnel↗
PubMed2001

A methodological note on combining health and social care expenditures into a single statistic for policy-making purposes.

Current national expenditure series in the health sector focus predominantly on spending for medical services. However, as the percentage of elderly individuals grows, national policy makers will increasingly require an expenditure series which includes combined expenditure for social care as well as medical expenditures. In one country, Sweden, national policy makers have begun to relate policy decisions to a 12.0% (1996) figure for combined health and social care expenditures. Calculating such a combined figure presents a number of methodological issues, such as which social care services to include and how to reflect donated care from relatives and friends. An international comparison of this new health and social care figure would enable national decision makers to judge better the efficiency and effectiveness of current policy.

Benchmarking↗
PubMed2002

The role of evidence in health policy making: a normative perspective.

Assessment of evidence is becoming a central part of health policy decisions--not least in limit setting decisions. Limit-setting decisions can be defined as the withholding of potentially beneficial health care. This article seeks to explore the value choices related to the use of evidence in limit-setting decisions at the political level. To better specify the important but restricted role of evidence in such decisions, the value choices of relevance are discussed explicitly. Four criteria are often considered when setting limits: 1. The severity of disease if untreated or treated by standard care 2. The effectiveness of the new technology 3. The cost-effectiveness of the new technology 4. The quality of evidence on (1)-(3) The production and assessment of evidence is important for each criterion, but several points are identified where the practice of evidence-based medicine could be further developed to capture a broader spectrum of ethical and political concerns that such decisions naturally evoke among citizens.

Cost-Benefit Analysis↗
PubMed2005

The effects of structures on decision-making policies in health care.

BACKGROUND: There is plenty of evidence in the literature indicating how difficult it is to recognize, question and eventually change our current mental models of the structures and decision-making processes in health care. The citizens of western countries are offered more health care services than ever and report themselves to be somatically healthier than ever. Paradoxically, many health care systems claim to be in a state of crisis, for which the cure is believed to more services and more money. Growth is a major feature of modern medicine and most people assume that more medical care must lead to improved health and wellbeing. However, adding more resources and more health care may also have counterintuitive effects. OBJECTIVE: This perspective describes common phenomena seen in our health care structures and searches for reports and results that may challenge some of the 'self-evident' solutions to these problems. RESULTS AND DISCUSSION: Most organizations and systems learn poorly and it is difficult to recognize how we contribute to our own problems and crisis. Even if the evidence has been apparent for decades, it may simply be ignored or rejected when it is inconsistent with the underlying beliefs. Learning seems to be associated more with attitudes and mental models than with evidence. As we are part of the health care structure, we share responsibility for problems generated by the system. It is time for health care professionals to study and question the efficacy of our current paradigms and practices.

Decision Making↗
PubMed2002

On values and democratic policy making: the deceptively fragile consensus around market-oriented medical care.

Market-oriented strategies, embodied in managed competition, have become the primary focus of contemporary U.S. health policy. This dominance reflects the emergence of a bipartisan coalition of support among political elites. This study traces the historical evolution of elite support for the market and suggests that the consensus favoring managed competition is deceptively fragile, with support riven by cleavages in the values used to judge fairness in the allocation of medical care. A unique data set of matched questions asked of both policy elites and the general public is used to document these differences in ethical norms. The implications of these cleavages help to explain three puzzling aspects of contemporary U.S. health policy: (1) the persisting inability to translate the principles of managed competition into politically feasible reforms, (2) the repeated failures to implement demonstration projects intended to test competitive pricing within the Medicare program, and (3) the inability of state regulations to assuage the public's concerns about managed care. Some prescriptions for a more revealing and effective treatment of market reforms in health policy conclude this study.

Consensus↗