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

The Milbank Memorial Fund quarterly.

Published by: PRODIST, a division of Neale Watson Academic Publications, Inc., -1977; by: Milbank Memorial Fund, 1978-Title from coverMode of access: Internet.Also available in microform: Microfilm.UCLA Library - CDL shared resource

What price better health?: hazards of the research imperative

The idea that we have an unlimited moral imperative to pursue medical research is deeply rooted in American society and medicine. In this provocative work, Daniel Callahan exposes the ways in which such a seemingly high and humane ideal can be corrupted and distorted into a harmful practice. Medical research, with its power to attract money and political support, and its promise of cures for a wide range of medical burdens, has good and bad sides - which are often indistinguishable. In What Price Better Health?, Callahan teases out the distinctions and differences, revealing the difficulties that result when the research imperative is suffused with excessive zeal, adulterated by the profit motive, or used to justify cutting moral corners. Exploring the National Institutes of Health's annual budget, the inflated estimates of health care cost savings that result from research, the high prices charged by drug companies, the use and misuse of human subjects for medical testing, and the controversies surrounding human cloning and stem cell research, Callahan clarifies the fine line between doing good and doing harm in the name of medical progress. His work shows that medical research must be understood in light of other social and economic needs and how even the research imperative, dedicated to the highest human good, has its limits

University of California Press eScholarship editions

One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy.The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing.In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine - overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions - factors often overlooked when newer organizational models are criticized.Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful - and optimistic - view of a future health care system, one in which physician entrepreneurship is a dynamic component

Public health law and ethics: a reader

This incisive selection of government reports, scholarly articles, and court cases is designed to illuminate the ethical, legal, and political issues in the theory and practice of public health. A companion to the internationally acclaimed Public Health Law: Power, Duty, Restraint, this collection encourages debate and discourse about how courts, scholars, and policy makers respond to the salient legal and ethical dilemmas. The excerpts and commentaries in the reader analyze the legal and constitutional foundations of public health, juxtaposing them with the emerging importance of public health ethics and human rights. The book offers a systematic account of public health law, ethics, and human rights in promoting the common good. Gostin provides thoughtful commentary on the field of public health and carefully explains the meaning and importance of each selection. Scholars, legislators, and public health professionals, as well as faculty and students in schools of law, public health, medicine, nursing, government, and health administration, will benefit from the contemporary case studies covering a wide range of topics from bioterrorism to public health genetics