166 research outputs found
Welfarism vs. extra-welfarism
'Extra-welfarism' has received some attention in health economics, yet there is little consensus on what distinguishes it from more conventional 'welfarist economics'. In this paper, we seek to identify the characteristics of each in order to make a systematic comparison of the ways in which they evaluate alternative social states. The focus, though this is not intended to be exclusive, is on health. Specifically, we highlight four areas in which the two schools differ: (i) the outcomes considered relevant in an evaluation; (ii) the sources of valuation of the relevant outcomes; (iii) the basis of weighting of relevant outcomes and (iv) interpersonal comparisons. We conclude that these differences are substantive. (C) 2007 Elsevier B.V. All rights reserved
Social and ethical criteria for prioritizing patients: a survey of students and health professionals in Portugal
O estudo quali-quantitativo explora
o dilema ético da microalocação dos recursos da
saĂșde. Objetiva identificar e comparar a opiniĂŁo
de dois grupos da sociedade portuguesa - estudantes
e profissionais de saĂșde sobre a importĂąncia
das caracterĂsticas pessoais dos pacientes no momento
de os priorizar e se as escolhas se explicam
por referenciais bioéticos de caråter utilitaristas ou
deontológicos. Os dados foram recolhidos através
de um questionĂĄrio aplicado a uma amostra de
180 estudantes universitĂĄrios e 60 profissionais de
saĂșde. Os respondentes perante hipotĂ©ticos cenĂĄ-
rios de emergĂȘncia clĂnica tiveram de escolher de
entre dois pacientes (distinguidos por idade, sexo,
responsabilidade social, situação económica e laboral,
comportamentos lesivos da saĂșde e registo
criminal) quem tratar e justificar a escolha. Foram
usados testes estatĂsticos de associação para
comparar as respostas dos dois grupos e anĂĄlise
de conteĂșdo para categorizar as justificaçÔes. Os
resultados sugerem a existĂȘncia de diferenças nas
escolhas dos dois grupos, com os profissionais de
saĂșde a revelarem aceitar menos a utilização de
critĂ©rios sociais em contexto de escassez e coexistĂȘncia
de critérios utilitaristas e deontológicos,
com predomĂnio da eficiĂȘncia por parte dos profissionais
de saĂșde e da equidade por parte dos
estudantesThis qualitative/quantitative study examines
the ethical dilemma of microallocation of
health resources. It seeks to identify and compare
the opinion of two groups in Portuguese society
â students and health professionals â on the importance
of personal characteristics of patients at
the moment of prioritizing them and if the choices
can be explained by bioethical references of a
utilitarian or deontological nature. Data were
collected by means of a questionnaire administered
to a sample of 180 students and 60 health
professionals. Faced with hypothetical emergency
scenarios, the respondents had to choose between
two patients (distinguished by: age, gender, social
responsibility, economic and employment
situation, harmful health behaviors and criminal
record), duly selecting who to treat and then
justifying their choice. The results suggest the existence
of differences in choices between the two
groups, with health professionals revealing they
are less prepared to accept the use of social criteria
in a context of scarce resources and co-existence
of utilitarian and deontological criteria, with a
predominance of efficiency on the part of health
professionals and equity on the part of students.info:eu-repo/semantics/publishedVersio
Lessons from the evaluation of the UK's NHS R&D Implementation Methods Programme
Background: Concern about the effective use of research was a major factor behind the creation
of the NHS R&D Programme in 1991. In 1994, an advisory group was established to identify
research priorities in research implementation. The Implementation Methods Programme (IMP)
flowed from this, and its commissioning group funded 36 projects. In 2000 responsibility for the
programme passed to the National Co-ordinating Centre for NHS Service Delivery and
Organisation R&D, which asked the Health Economics Research Group (HERG), Brunel University,
to conduct an evaluation in 2002. By then most projects had been completed. This evaluation was
intended to cover: the quality of outputs, lessons to be learnt about the communication strategy
and the commissioning process, and the benefits from the projects.
Methods: We adopted a wide range of quantitative and qualitative methods. They included:
documentary analysis, interviews with key actors, questionnaires to the funded lead researchers,
questionnaires to potential users, and desk analysis.
Results: Quantitative assessment of outputs and dissemination revealed that the IMP funded useful
research projects, some of which had considerable impact against the various categories in the
HERG payback model, such as publications, further research, research training, impact on health
policy, and clinical practice.
Qualitative findings from interviews with advisory and commissioning group members indicated
that when the IMP was established, implementation research was a relatively unexplored field. This
was reflected in the understanding brought to their roles by members of the advisory and
commissioning groups, in the way priorities for research were chosen and developed, and in how
the research projects were commissioned. The ideological and methodological debates associated
with these decisions have continued among those working in this field. The need for an effective
communication strategy for the programme as a whole was particularly important. However, such
a strategy was never developed, making it difficult to establish the general influence of the IMP as a
programme.
Conclusion: Our findings about the impact of the work funded, and the difficulties faced by those
developing the IMP, have implications for the development of strategic programmes of research in
general, as well as for the development of more effective research in this field
Who needs what from a national health research system: Lessons from reforms to the English Department of Health's R&D system
This article has been made available through the Brunel Open Access Publishing Fund.Health research systems consist of diverse groups who have some role in health research, but the boundaries around such a system are not clear-cut. To explore what various stakeholders need we reviewed the literature including that on the history of English health R&D reforms, and we also applied some relevant conceptual frameworks.
We first describe the needs and capabilities of the main groups of stakeholders in health research systems, and explain key features of policymaking systems within which these stakeholders operate in the UK. The five groups are policymakers (and health care managers), health professionals, patients and the general public, industry, and researchers. As individuals and as organisations they have a range of needs from the health research system, but should also develop specific capabilities in order to contribute effectively to the system and benefit from it.
Second, we discuss key phases of reform in the development of the English health research system over four decades -
especially that of the English Department of Health's R&D system - and identify how far legitimate demands of key stakeholder interests were addressed.
Third, in drawing lessons we highlight points emerging from contemporary reports, but also attempt to identify issues through application of relevant conceptual frameworks. The main lessons are: the importance of comprehensively addressing the diverse needs of various interacting institutions and stakeholders; the desirability of developing facilitating mechanisms at interfaces between the health research system and its various stakeholders; and the importance of additional money in being able to expand the scope of the health research system whilst maintaining support for basic science.
We conclude that the latest health R&D strategy in England builds on recent progress and tackles acknowledged weaknesses. The strategy goes a considerable way to identifying and more effectively meeting the needs of key groups such as medical academics, patients and industry, and has been remarkably successful in increasing the funding for health research. There are still areas that might benefit from further recognition and resourcing, but the lessons identified, and progress made by the reforms are relevant for the design and coordination of national health research systems beyond England.This article is available through the Brunel Open Access Publishing Fund
Comorbidity of Reading and Mathematics Disabilities
Although children with learning disabilities frequently manifest comorbid reading and mathematics deficits, the cause of this comorbidity is unknown. To assess the extent to which comorbidity between reading and mathematics deficits is due to genetic and environmental influences, we conducted a twin study of reading and mathematics performance. Data from 148 identical and 111 fraternal twin pairs in which at least one member of the pair had a reading disability were subjected to a cross-concordance analysis and also fitted to a bivariate extension of the basic multiple regression model for the analysis of selected twin data. Results of these analyses suggest that genetic and shared-environmental influences both contribute to the observed covariance between reading and mathematics deficits.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68572/2/10.1177_002221949502800204.pd
Opportunity costs and local health service spending decisions: a qualitative study from Wales
How Can We Support the Use of Systematic Reviews in Policymaking?
John Lavis discusses how health policymakers and their stakeholders need research evidence, and the best ways evidence can be synthesized and packaged to optimize its use
Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?
Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure
Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions
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