[EQ] Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs

Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs

 

Nancy E. Adler and Ann E. K. Page, Editors

Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting
Board on Health Care Services (HCS) – US Institute of Medicine (IOM) - 2008

 

Available online Free Book – also PDF [47p.] Summary:

“…….Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological
 and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of
health care and thereby adversely affect the health of cancer patients.

 

Psychological and social problems created or exacerbated by cancer--including depression and other emotional
problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and
disruptions in work, school, and family life--cause additional suffering, weaken adherence to prescribed treatments,
and threaten patients' return to health.

 

Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to
address patients' psychosocial health needs. All patients with cancer and their families should expect and receive
cancer care that ensures the provision of appropriate psychosocial health services.

Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators,
health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake
to ensure that this standard is met….”

 

Content:

 

Front Matter

Summary

1 The Psychosocial Needs of Cancer Patients

2 Consequences of Unmet Psychosocial Needs

3 Psychosocial Health Services

4 A Model for Delivering Psychosocial Health Services

5 Implementing the Standard of Care

6 Public- and Private-Sector Policy Support

7 Preparing the Workforce

8 A Research Agenda

Appendix A: Committee Member Biographies

Appendix B: Study Methods

Appendix C: Recommendations from Prior Selected Reports

 

 

 

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[EQ] Developing Good Taste in Evidence: Facilitators of and Hindrances to Evidence-Informed Health Policymaking

 “Developing Good Taste in Evidence”:
Facilitators of and Hindrances to Evidence-Informed Health Policymaking in State Government

Christopher J . Jewell and Lisa A. Bero
University of California, San Francisco
The Milbank Quarterly, Volume 86, Number 2, June  2008

Available online at: http://www.milbank.org/quarterly/8602feat.html

Context: Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real-life context in which policymakers are situated and make decisions also is crucial to the development of evidence-informed policy.

Methods: This qualitative study expands on other studies of research utilization at the state level through interviews with twenty-eight state legislators and administrators about their real-life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances.

Findings: Hindrances to evidence-informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence-based skills; and developing research venues and collaborative relationships in order to generate relevant evidence.

Conclusions: Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence-informed health policymaking are amenable to change. Policymakers could benefit from evidence-based skills training to help them identify and evaluate high-quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy.

 

Endnotes: A systematic review is a review of a clearly formulated question that uses explicit methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review. A meta-analysis refers to the use of statistical methods to integrate the results of the included studies (http://www.cochrane.org/index.htm).

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

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[EQ] Review of Australian health economic evaluation - 245 interventions: what can we say about cost effectiveness?

Review of Australian health economic evaluation – 245 interventions: what can we say about cost effectiveness?

Kim Dalziel1  , Leonie Segal1  and Duncan Mortimer1,2 
1Health Economics and Policy Group, Division of Health Sciences, University of South Australia, Adelaide, Australia
2Centre for Health Economics, Monash University, Melbourne, Australia

Cost Effectiveness and Resource Allocation – May 2008, 6:9doi:10.1186/1478-7547-6-9

Available online at: http://www.resource-allocation.com/content/6/1/9

Background

There is an increasing body of published cost-utility analyses of health interventions which we sought to draw together to inform research and policy.

Methods

To achieve consistency in costing base and policy context, study scope was limited to Australian-based cost-effectiveness analyses. Through a comprehensive literature review we identified 245 health care interventions that met our study criteria.

Results

The median cost-effectiveness ratio was A$18,100 (~US$13,000) per QALY/DALY/LY (quality adjusted life year gained or, disability adjusted life year averted or life year gained). Some modalities tended to perform worse, such as vaccinations and diagnostics (median cost/QALY $58,000 and $68,000 respectively), than others such as allied health, lifestyle, in-patient interventions (median cost/QALY/DALY/LY all at ~A$9,000~US$6,500). Interventions addressing some diseases such as diabetes and impaired glucose tolerance or alcohol and drug dependence tended to perform well (median cost/QALY/DALY/LY < A$3,700, < US$5,000). Interventions targeting younger persons < 25 years (median cost/QALY/DALY/LY < A$41,200) tended to perform less well than those targeting adults > 25 years (median cost/QALY/DALY/LY < A$16,000). However, there was also substantial variation in the cost effectiveness of individual interventions within and across all categories.

Conclusion

For any given condition, modality or setting there are likely to be examples of interventions that are cost effective and cost ineffective. It will be important for decision makers to make decisions based on the individual merits of an intervention rather than rely on broad generalisations. Further evaluation is warranted to address gaps in the literature and to ensure that evaluations are performed in areas with greatest potential benefit.

 

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

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and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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