Health Equity: 08/11/09

Tuesday, August 11, 2009

[EQ] Health Affairs - Is Health Policy Research Helping Decisionmakers? - The Unhealthy State Of Health Policy Research

Connecting The Ivory Tower To Main Street: 
 Setting Research Priorities For Real-World Impact

It's time to tighten the connections between health services researchers and private-sector decision makers so that research answers private payers' top questions.

by Claudia L. Schur, Marc L. Berk, Lauren E. Silver, Jill M. Yegian, and Michael J. O'Grady

Claudia Schur is vice president and director of the Center for Health Research and Policy, Social and Scientific Systems (SSS), in Silver Spring, Maryland. Marc Berk is group vice president and directs the Health Policy and Data Analysis Group at the center. Lauren Silver was a research analyst at the center and is now a doctoral student at Emory University. Jill Yegian is director of Research and Evaluation at the California HealthCare Foundation in Oakland. Michael O’Grady is a senior fellow at NORC in Bethesda, Maryland

Health Affairs 28, no. 5 (2009): w886-w899 (published online 11 August 2009; 10.1377/hlthaff.28.5.w886

Available online at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w886

ABSTRACT:
Health care decision makers face increasing pressure to use health care resources more efficiently, but the information they need to assess policy options often is unavailable or not disseminated in a useful form.
Findings from stakeholder meetings and a survey of private-sector health care decision makers in California begin to identify high-priority issues, the perceived adequacy of current information, and preferred formats and other desired attributes of research.
This is a first step in establishing a systematic approach to linking the information priorities of private-sector decision makers with those who fund and conduct research. Health Affairs 28, no. 5 (2009)

The Unhealthy State Of Health Policy Research

Sumit R. Majumdar ¹ Stephen B. Soumerai ^2*
¹ Sumit Majumdar is an associate professor in the Department of Medicine, University of Alberta, in Edmonton.
² Stephen Soumerai is a professor in the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, in Boston, Massachusetts.
Health Affairs 28, no. 5(2009): w900-w908 (published online 11 August 2009; 10.1377/hlthaff.28.5.w900)]

Poor-quality policy research can jeopardize the quality of policies that rely on that research--especially in an intense reform debate.

Available online at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w900

”…Health policies often represent large-scale natural experimentswith poorly understood risks and benefits. Unfortunately, researchersoften stray from the core principles of study design requiredto provide valid evidence.

The result is that policymakers andthe public do not always know what to believe. We illustratethe problem in several fields, including pay-for-performance,cost sharing, and health information technology policies.

Wesuggest a few ways to improve health policy research so thatevidence can inform policy more often. The way forward shouldinclude more credible data for those making the hard trade-offsbetween cost and quality of care….” Health Affairs 28, no. 5(2009):

* * * *
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/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Capacity planning in health care

Policy Brief

Capacity planning in health care - A review of the international experience

Reinhard Busse, Technische Universität Berlin;
Carl-Ardy Dubois, University of Montreal;
Isabelle Durand-Zaleski, Hôpital Henri Mondor, Paris;
Niek Klazinga, University of Amsterdam;
Allan Krasnik, University of Copenhagen;
Walter Ricciardi, Catholic University of the Sacred Heart, Rome;
Juha Teperi, National Research and Development Centre for Welfare and Health (STAKES), Helsinki

World Health Organization 2008, on behalf of the European Observatory on Health Systems and Policies

Available online as PDF [67p.] at: http://www.euro.who.int/Document/E91193.pdf

“……Health systems in most high-income countries aim to provide a comprehensive range of services to the entire population and to ensure that standards of quality, equity and responsiveness are maintained. Although approaches vary widely, responsibility for developing the overall framework for financing and organizing health care usually lies with the central government, while governance of the health system is often shared by central and regional authorities.

In this policy brief, we review approaches to capacity planning, a crucial component of health care governance. By concentrating on a selection of countries as diverse as Canada, Denmark, England, Finland, France, Germany, Italy, the Netherlands and New Zealand, we aim to show a range of approaches to health care financing and organization, since both of these factors have an impact on approaches to capacity planning.

In most countries, health care capacity planning takes place at national, regional or local level, reflecting the various tiers of government within health systems, but the distinction between these levels is not always clear cut. For example, regional and local authorities may oversee entities that differ greatly in terms of population size, legal and political mandates and organizational structures. In most of the countries we reviewed, health care capacity planning has been devolved to regional level (often reflecting devolution of overall responsibility for the organization of health care), with Denmark and Finland regarding local authorities as important actors….”

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[EQ] Medicine and public health in a multiethnic world

Medicine and public health in a multiethnic world

Raj Bhopal, Alexander Bruce and John Usher Professor of Public Health
Public Health Sciences, Centre for Population Health Sciences, University of Edinburgh

Journal of Public Health Advance Access published on July 7, 2009.
doi:10.1093/pubmed/fdp069

URL: http://jpubhealth.oxfordjournals.org/cgi/content/full/fdp069

“…….Achievement of medical and public health goals requires mutualunderstanding between professionals and the public, a challengein diverse societies. Despite their massive diversity humansbelong to one species, with race and ethnicity used to subgroup/classifyhumans and manage diversity.

Classifications are contextualand vary by time, place and classifier. As classifications showmajor variations in health status, and risk factors, researchusing race and ethnicity has accelerated. Medical sciences,including epidemiology, are learning fast to extract value fromsuch data.

Among the debatable issues is the value of the relativerisk versus absolute risk approaches (the latter is gainingground), and how to assess ethnicity and race (self-assignmentis favoured in the UK and North America, country of birth incontinental Europe).

Racial and ethnic variations in diseaseand risk factors are often large and usually unexplained. Thereis a compelling case for ethnic monitoring, despite its difficulties,for tackling inequalities and as a foundation for research.Medical and public health goals require good data collectedin a racism-free social environment. Health professionals needto find the benefits of exploring differences while avoidingsocial division. Advances in health care, public health andmedical science will follow….”

Scope of the paper

• the multiethnic society,

• migration,

• species, race and ethnicity,

• problems and benefits of using ethnicity and race in health,

• use and interpretation of variations in disease and health status by ethnic group,

• difference between inequalities and inequities,

• importance to medical sciences and clinical practice of inequalities and inequities,

• a vision of the doctor of the future…..”

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