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At least 19 recordsLinked to original sources
PubMed1993

Making clinical policy explicit. Legislative policy making and lessons for developing practice guidelines.

Promulgation of practice guidelines in medicine has increased interest in the structure of clinical policy making. It is argued that with a generic definition of policy as "the rules governing the behavior of individuals or institutions," clinical policy making is analogous to legislative policy making. Practice guidelines emphasize the advantages of making clinical policy more explicit. The structure of legislative policy making has evolved over many years to meet the challenge of making both the policies and the process of policy making explicit. Processes to promulgate clinical policies may be able to exploit this experience to improve clinical policy making and thereby retain control of the process within medicine. Generic steps are outlined for making decisions with incomplete information; synthesis of facts, vested interests, and values; involvement of stakeholders; and implementation of policy. An illustration of the use of the generic steps to make and implement a clinical policy for cesarean birth follows, with evaluations of its impact on the behavior and satisfaction of clinical stakeholders.

Canada↗
PubMed2000

Playing policy pinball: making policy analysis palatable.

The author presents a teaching tool to make policy analysis accessible to a wide range of audiences, especially those who might normally be reluctant to engage in policy discussions or debate. The tool has been used with good results in a variety of venues, and is presented with brief examples of how it can be used.

Economics↗
PubMed1980

Policy-making and governance in academic health centers.

Treating academic health centers (AHCs) as unique organizations that merit serious investigation, the authors outline key changes which have shaped today's AHCs, discuss various modes of AHC organization and governance, and analyze certain factors which make AHC policy-making so complex. In addition, they assess the relevance of certain policy-making models, concluding that no one model completely describes AHC governance. They suggest that the contingency theory of organizations offers a useful perspective on AHCs and point to matrix management as one contemporary method being tried in an effort to cope with the problems of AHC governance. Finally, the authors offer a set of decision-making continua as an alternative to governance models for analyzing policy-making in AHCs.

Academic Medical Centers↗
PubMed2006

Evidence-based policy-making.

There is no large literature on evidence-based policy-making. We do know that one of the most difficult decisions is about the dependability of evidence we use to make policy. Unless the evidence can fulfil the criteria of quality, validity, and size, then it has the potential to mislead us, whatever study designs or methods have been used. The best examples of evidence-based policy-making come from development of care pathways, in which multidisciplinary groups merge best-available evidence with what is possible in local circumstances. These care pathways almost always have the ability to deliver better care for patients, with less fuss for professionals and at lower cost to the community. They may be the single best way of improving healthcare.

Evidence-Based Medicine↗
PubMed1999

Implications of social class and race for urban public health policy making: a case study of HIV/AIDS and TB policy in Washington, DC.

This paper explores how social class and race affect the public health policy-making process in an urban area. Ethnographic methods were used to collect and analyze information about HIV/AIDS and tuberculosis policy-making by the Washington, DC Commission of Public Health, Kingdon's conceptual model of policy making was used to analyze and understand the process. The problems of HIV/AIDS and tuberculosis in the district have important social class dimensions that were not always made explicit, but were instead defined in terms of 'race' and 'place'. Social class considerations and racial politics shaped what policies were developed or not developed and implemented successfully or failed. This study, which has national and international implications, concludes that there is a need to improve our understanding of the complex social dimensions of public health problems; there needs to be more consideration of the politics of strategy formulation and how issues of social class and race affect this process; and public health needs to strengthen its constituency in order to build support for the successful development and implementation of policy.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Risk assessment in environmental policy-making.

Environmental policy-making has become more dependent on formal, quantitative risk assessment because of increasing attention to the prevention of human health damage from toxic chemicals. Risk assessment helps set priorities for regulation of the very large numbers of chemicals that are of potential concern and helps direct limited social and government resources against the most significant risks. Although the scientific basis for risk assessment is often uncertain and the public and its representatives have often been confused by its use in regulatory decisions, the U.S. Environmental Protection Agency currently uses a variety of risk assessment techniques to set priorities, tailor regulations, and make decisions at particular sites. The Environmental Protection Agency also attempts to make the practice of risk assessment more consistent throughout the agency and to improve public understanding of the meaning of risk assessment and risk management.

Environmental Exposure↗
PubMed2002

Risk assessment in regulatory policy making for human and veterinary public health.

Risk assessment is the method of systematically identifying and assessing factors that influence the probability and consequences of a negative event occurring. One responsibility of veterinary medicine is to protect animal and human health. Food animal production uses antibiotics to enhance production. Regulators evaluate new production technology to ensure animal safety and safe, edible products and to make public policy decisions by assessing risks/benefits. The U.S. Food and Drug Administration, Center for Veterinary Medicine's (CVM's) first risk assessment addressed the potential human health impact of campylobacter effects associated with the use of fluoroquinolines in food-producing animals. CVM used the Monte Carlo method to estimate risk byprobability distributions that reflect the uncertainty and variability in the data used for the assessment. Enterococci faecium is a species more likely to be resistant to antibiotics of last resort. Effective control of multidrug-resistant enterococci will requirea better understanding of the transfer of E. faeciumfrom animals to humans and the interaction between E. faecium, the hospital environment, and humans; prudent antibiotic use; better contact isolation in hospitals; and better surveillance. CVM will model these factors in a second, more complex risk assessment designed to examine the indirect transfer of resistance from animals to humans. Use of risk assessments allows researchers, the industry, regulatory authorities, and educators to make better policy decisions regarding antimicrobial use in food animals and humans and the development of resistance. Today the question of whether the use of antimicrobials for growth enhancement infood animals should or should not be terminated for the benefit of human health remains unresolved.

Animals↗
PubMedDate not supplied

[Policy-making tiers of the Unified Health System (SUS) in the State of Rio de Janeiro and the decision-making process].

The literature concerning governmental policy-making generally encompasses the entire policy-making field. This study focused on one particular aspect of this process in the State of Rio de Janeiro, from January 1998 to July 1999: the formal decision-making tiers represented by State Health Council (CES) and the Bipartite Inter-Managerial Commission (CIB), as well as the relationships between these councils and the State Health Secretariat (SES), which holds political responsibility for approving or rejecting decisions and is thus a key player in the implementation of the Unified Health System (SUS) at the State level. Despite the political confrontation among the SES, CIB, and CES, we have observed that the new design in health policy vis-à-vis the decision-making process has fostered increasing influence by social actors involved in decisions and that the negotiated arrangements, although the result of a given correlation of forces, have favored the democratization of policy-making in the health sector.

Brazil↗
PubMed1997

The problem with making AIDS comfortable: federal policy making and the rhetoric of innocence.

This essay presents a narrative of U.S. AIDS policy which highlights the ways that people with AIDS (PWAs) have been categorized throughout the epidemic. I argue that PWAs have been broadly categorized as either "innocent" or "guilty" in the public discourse about AIDS, and that these distinctions have greatly influenced the way that policies are designed and justified. An examination of the Ryan White CARE Act of 1990 shows that policy rationales of lawmakers overwhelmingly relied on rhetoric which focused on the most sympathetic PWAs: "innocent" women and children. While this rhetorical strategy helped gain passage of the law, it effectively shut out the concerns of the majority of PWAs who fell into less sympathetic categories and resulted in policy decisions which often work against the stated goals of lawmakers.

Acquired Immunodeficiency Syndrome↗
PubMed2003

The utilisation of health research in policy-making: concepts, examples and methods of assessment.

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions.The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation.Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation.Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis.Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.

Journal Article↗
PubMed1975

The functions of progressionals in gerontology in policy making: a case history from Massachusetts.

This paper describes and assess the functions which a Professional Task Force Committee has performed as an advisory body to the State Unit on Aging in Massachusetts, the Executive Office of Elder Affairs, and how this committee has aided in its development in the past 2 years. As such it illustrates the kind of contributions which professionals in gerontology can make in policy-making for the elderly. This experience in Massachusetts has demonstrated that a body of professionals linked together through an appropriate structure, can shape and effect policies that a State Unit on Aging eventually promulgates. The expert can and should make his expertise available in policy anlysis, policy development, and in policy implementation. But, at the same time, the expert must recognize that, like everybody else, he needs a corrective; otherwise expert power will be guiding too much the direction of a State Unit on Aging (or any other government department) and this may not always be in the interest of those who are going to receive services and to be the beneficiaries of social programs.

Aged↗
PubMed1995

Prevention and government: health policy making in the United Kingdom and Germany.

The gap between rhetoric and reality in health policy making for disease prevention services is well recognized. I do not try once more to close the gap, but rather argue that the rhetoric of prevention is politically significant. Beginning with an account of prevailing explanations of prevention in policy making, I explore the idea that prevention has a pervasive legitimacy in health politics. This affords opportunities for instrumental policy making by government. To this end, I concentrate on the relationship between disease prevention and health care delivery, discussing in detail the association between prevention and health care reform. My arguments are based on case studies of policy making in Germany and the United Kingdom. I discuss implications for understanding the core interests of government, physicians, and users with respect to prevention in health policy making. The concluding section offers comparative commentary on the role of disease prevention in health sector restructuring.

Cross-Cultural Comparison↗
PubMed1997

Fighting tuberculosis in the 1990s: how effective is planning in policy making?

Planning is a common tool for addressing important health issues, especially urgent ones, and has been reintroduced recently in several federal, state, and local public health programs. This article presents a case study of planning and policy making concerning the reemergence of tuberculosis in urban areas, using Washington, D.C. and New York City as examples. Planning was unsuccessful in D.C. because it failed to acknowledge the important political and bureaucratic aspects of policy making. In New York City, on the other hand, planning played a central role in policy-making efforts, and the health department took a leadership role in building a consensus on the problem, formulating strategies, and overcoming implementation obstacles. This article concludes with several key considerations for making planning more effective in health policy-making.

Communicable Disease Control↗
PubMed1999

The role of research evidence in pharmaceutical policy making: evidence when necessary but not necessarily evidence.

The use of research evidence in policy making at the legislative and administrative levels would appear to be very selective. Focusing on pharmaceutical policy, this paper argues that research evidence is only one ingredient leading to a policy decision and that any examination of research transfer into policy must take into account the many other factors which impact on decision making. The paper describes the policy making process, barriers to the uptake of research evidence into policy and ways of improving research uptake into policy making. Examples are given from drug licensing, remuneration policies, post-marketing surveillance and product withdrawal from the market.

Drug and Narcotic Control↗
PubMedDate not supplied

Perspectives on functional assessment: its use for policy making.

Functional assessment has the power to decide who receives care, for how much and by whom. Yet, despite its perceived value for setting public policy, these tools are often described as either flawed or formative in their development. Thus, policy-making using functional assessment could be considered premature during a time when cost and quality controls are overdue. Such a dilemma pits consumers, practitioners and researchers against policy-makers and payers as health-care decisions hang in the balance. This article presents the views of key constituencies on the readiness of functional assessment for policy-making. The discussion, focused primarily on setting health-care policy in the United States, is framed against a profile of health-care trends, within the context of the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps, and with reference to the characteristics of selected tools in widespread use. These perspectives may shed light on ways to proceed for building confidence in the tools' viability for policy-making.

Activities of Daily Living↗
PubMed2006

The women's health movement: making policy, 1970-1995.

With the advent of second-wave feminism during the 1970s, a significant body of literature emerged describing sexist practices in women's health care. Gender-bias and gender disparities found in women's health care became concerns that garnered considerable attention in the United States because of the increased health risks posed for women. This article describes key historical challenges and accomplishments made in U.S. women's health care policy during the quarter century spanning 1970-1995 that influence contemporary health care social work practice and social work education.

Female↗