Using population-based routine data for evidence-based health policy decisions: lessons from three examples of setting and evaluating national health policy in Australia, the UK and the USA

2007 ◽  
Vol 29 (4) ◽  
pp. 463-471 ◽  
Author(s):  
E. H. Morrato ◽  
M. Elias ◽  
C. A. Gericke
2010 ◽  
Vol 18 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Janet Marsden ◽  
Mary E. Shaw ◽  
Sue Raynel

This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional regulation on such roles. A mixed method questionnaire design was used, distributed at national ophthalmic nursing conferences in the UK and in New Zealand. Participants were nurses undertaking advanced practice who opted to return the questionnaire. Data were analysed separately, and are compared here, integrated with national health policy and role regulation to provide commentary on the findings. The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge. The drivers of role development appear similar and include a lack of experienced doctors and an unmanageable rise in healthcare demand. Titles and remuneration are different in the two health economies, reflecting the organisation and regulation of nursing. In clinical terms, there are few differences between practice in the two settings and it appears that the distinct systems of regulation have minimal effect on role development. Ophthalmic nursing, as a reactive, needs based profession and in common with nursing in general, evolves in order that practice reflects what is needed by patients and services.


1981 ◽  
Vol 26 (2) ◽  
pp. 88-89
Author(s):  
Theodore H. Blau

2011 ◽  
Vol 60 (1) ◽  
pp. 20-43 ◽  
Author(s):  
Robert Geyer

For much of the twentieth century UK public policy has been based on a strong centralist, rationalist and managerialist framework. This orientation was significantly amplified by New Labour in the 1990s and 2000s, leading to the development of ‘evidence-based policy making’ (EBPM) and the ‘audit culture’ – a trend that looks set to continue under the current government. Substantial criticisms have been raised against the targeting/audit strategies of the audit culture and other forms of EBPM, particularly in complex policy areas. This article accepts these criticisms and argues that in order to move beyond these problems one must not only look at the basic foundation of policy strategies, but also develop practical alternatives to those strategies. To that end, the article examines one of the most basic and common tools of the targeting/audit culture, the aggregate linear X-Y graph, and shows that when it has been applied to UK education policy, it leads to: (1) an extrapolation tendency; (2) a fluctuating ‘crisis–success' policy response process; and (3) an intensifying targeting/auditing trend. To move beyond these problems, one needs a visual metaphor which combines an ability to see the direction of policy travel with an aspect of continual openness that undermines the extrapolation tendency, crisis–success policy response and targeting/auditing trend. Using a general complexity approach, and building on the work of Geyer and Rihani, this article will attempt to show that a ‘complexity cascade’ tool can be used to overcome these weaknesses and avoid their negative effects in both education and health policy in the UK.


Author(s):  
Alex Rajczi

Most Americans see the need for a national health policy that guarantees reasonable access to health insurance for all citizens, but some worry that a universal health insurance system would be inefficient, create excessive fiscal risk, or demand too much of them, either by increasing their taxes or by rendering their own health insurance unaffordable. After describing these three objections and the role they play in health care debates, the introduction outlines the contents of each chapter. It concludes with some remarks about how data will be handled in the book’s later chapters.


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