Health Equity: 03/09/09

Monday, March 9, 2009

[EQ] Exploring the impact of primary health care research

Exploring the impact of primary health care research

Final Report Stage 2 Primary Health Care Research Impact project

- PHC RIS Research team

Libby Kalucy, Eleanor Jackson Bowers, Ellen McIntyre, Ann-Louise Hordacre, Richard Reed,
Australia: Primary Health Care Research & Information Service - February 2009

Available online as PDF file [54p.] at:
http://www.phcris.org.au/phplib/filedownload.php?file=/elib/lib/downloaded_files/publications/pdfs/phcris_pub_8108.pdf

“…..This report presents the results of a study conducted in 2007 by the Primary Health Care Research and Information Service, on seventeen diverse primary health care research projects funded by national competitive grants in Australia. The study aimed to examine, from the perspective of the chief investigators (CIs), the impact of these research projects and to explore how their projects

made an impact….”

“….Measuring the impact of primary health care research is an important but inexact science. While a research team has a great deal of influence on the outputs and immediate outcomes of their research project, the process of transferring research findings into practice and policy is convoluted and indirect. It can take many years for the findings of a research project to result in changes in health outcomes and health services. The longer the time, the more difficult it is to track impacts reliably and attribute them to the project. Changes to practice and policy are usually the result of evidence from a whole body of work, rather than from a single research project…” Libby Kalucy

Contents

Preface

Executive summary

Recommendations to enhance impact

For Research Funders

For Researchers

For the Australian Government

For PHC RIS8

Introduction

Methodology

The sample

Questionnaire design

What difference does Primary Health Care research make?

Impacts Expected by Chief Investigators

Impacts achieved overall

Impacts achieved by domain

Research Transfer

University engagement with user groups

Enhanced relationships for research transfer

Knowledge Production

Research Targeting and Capacity Building

Informing policy and product development

Policy development

Organisational decision making

Use in Education

Informed Product Development

Use in practice guidelines or a systematic review

Health and Health Sector Benefits

Implemented in Practice and/or Service Delivery

Contributed to more equitable allocation of resources, better targeting of resources or improved access to services

Cost Savings

Improved Health Outcomes

Intellectual Property Gains

Broader Economic Benefits.

Improvements in population health

Other economic and social impacts

Summary

What are the pathways to impact?

Research Transfer

Knowledge Production

Research Targeting and Capacity Building

Informing Policy and Product Development

Involvement of policy makers in the research informed policy development

Involvement with multiple related projects enhanced policy impact

Chief Investigator’s participation on committees

Incorporation of the findings into education programs and professional guidelines

Facilitating organisations

Congruence with Government agendas enhanced policy impact

Champions

Health and the Health Sector

Inclusion in an education program

Raising awareness

Impact on health outcomes

Longer term impacts

Broader economic benefits

Theoretical models of pathways to impact

Linkage and exchange

Social embeddedness and social capital

Role of ideas

Communities of practice

Discussion

Dissemination

Limitations of the study

Further research on research impact

Conclusions

References

Appendix 1: Brief project descriptions

Appendix 2: Sample summary

Appendix 3: The questionnaire

Appendix 4: Impacts of research projects in relation to their intention

Appendix 5: Comparison of results with other studies of research impact using the Payback Framework

Appendix 6: Journals in which articles from study sample were published, with impact factors

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[EQ] Priority setting: what constitutes success? A conceptual framework

Priority setting: what constitutes success?
A conceptual framework for successful priority setting

Shannon L Sibbald1,2*, Peter A. Singer3, Ross Upshur2,4, Douglas K Martin1,2

1 Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

2University of Toronto Joint Centre for Bioethics, Toronto, Canada

3 The McLaughlin-Rotman Centre for Global Health, Toronto, Canada

4Sunnybrook Health Science Centre, Toronto, Canada
BMC Health Services Research – March 9, 2009 -- 9:43 doi:10.1186/1472-6963-9-43

Available online at: http://www.biomedcentral.com/content/pdf/1472-6963-9-43.pdf

Background: The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean.
The goal of this research was to develop a conceptual framework for successful priority setting.

Methods: Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries).

Results: This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism.

Conclusions: The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting.

The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts…”

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[EQ] Toward Health Equity and Patient-Centeredness

Toward Health Equity and Patient-Centeredness:

Integrating Health Literacy, Disparities Reduction, and Quality Improvement: Workshop Summary

Rapporteurs: Samantha Chao, Karen Anderson, and Lyla Hernandez
Forum on the Science of Health Care Quality Improvement and Implementation;
Roundtable on Health Disparities; Roundtable on Health Literacy; Institute of Medicine, 2009

Available online at; http://www.nap.edu/catalog.php?record_id=12502

“….To receive the greatest value for health care, it is important to focus on issues of quality and disparity, and the ability of individuals to make appropriate decisions based on basic health knowledge and services.

During this workshop, speakers and participants explored how equity in care delivered and a focus on patients could be improved….”

“…..The workshop began with the presentation of a vision for integrating disparities reduction, health literacy, and quality improvement to achieve better outcomes, followed by a panel of speakers who addressed building a foundation for integration of these three areas. A second panel addressed using quality improvement as a tool to improve health literacy and reduce disparities at the practitioner level

Discussion Groups centered questions on:
• What specific activities could be undertaken to effectively integrate quality improvement, disparities reduction, and improved health literacy?

• How can such integration be more patient-centered?

• What systems integration and systems changes might be necessary to achieve greater patient-centeredness and equity?

A third panel discussed policy issues related to integration, including standards and priorities that could foster improvement in patient-centered care and equity; types of measures that could be developed to understand the contributions of health literacy and disparities reduction to improved quality; how efforts at integration could be evaluated; and issues of financing, education, and training….”

Content:

1 Introduction

2 Opportunity at the Intersection of Quality Improvement, Disparities Reduction, and Health Literacy

3 Building the Foundation for Integrating Health Literacy, Disparities Reduction, and Quality Improvement in Health and Health Care

4 Integration at the Practitioner Level

5 Breakout Groups

6 Policy Issues of Integration

7 Concluding Remarks

References

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    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.