Diagnosis and prognosis of Australia&s health information for evidence-based policy

2002 ◽  
Vol 7 (1_suppl) ◽  
pp. 40-45 ◽  
Author(s):  
Kees Van Gool ◽  
Emily Lancsar ◽  
Rosalie Viney ◽  
Jane Hall ◽  
Philip Haywood
Keyword(s):  
Health Information ◽  
Waiting Times ◽  
Specific Treatment ◽  
Waiting Lists ◽  
Data Availability ◽  
Evidence Based ◽  
Cost Shifting ◽  
Public And Private ◽  
Evidence Based Policy ◽  
The Impact

Without adequate information it is difficult to determine the success or failure of health policies. This paper assesses the adequacy of Australia&s health information for evidence-based policy. Three policy areas are analysed: the impact of changing the public and private health financing mix; waiting lists and waiting times; and pooling of funds. In each, the issue is analysed to identify the key policy questions, the available data and existing analyses are examined, and gaps in data availability and analysis are assessed. There is variability in the extent and usefulness of current health information. In terms of the impact of changing the financing mix, there is good information on the distribution of finance, but much less available on comparative use or efficiency of public and private hospitals. There is comprehensive information available on waiting lists and waiting times but little analysis of the implications of this for equity of access or the costs and benefits of reducing waiting times. There is insufficient information for the development of the capitation based formulae required for the introduction of the pooling of funds, nor enough information to assess the extent and impact of current cost-shifting which might be addressed by pooling funds. While the concept of evidence-based medicine has been embraced with regard to specific treatment decisions, there has not been a parallel investment in the use of evidence to drive policy decisions.

The search for impact in British probation: from programmes to skills and implementation

2017 ◽  
Author(s):  
Peter Raynor
Keyword(s):  
Evidence Based ◽  
Quantitative Methodology ◽  
Social Scientists ◽  
Qualitative And Quantitative ◽  
What Works ◽  
Evidence Based Policy ◽  
History Of ◽  
Evaluative Research ◽  
The Impact

Social scientists have often had difficulty evaluating the impact of probation services, partly because expectations and political circumstances change and partly because appropriate methodologies have been slow to develop. This chapter outlines the history of evaluative research on probation. It describes the limitations of early probation research which led to erroneous conclusions that ‘nothing works’, and goes on to show how more recent research has been based on a fuller understanding of practitioner inputs through research on programmes, skills and implementation. This is starting to lead to a better understanding of which practices are effective (‘What Works’). The chapter advocates a mixed qualitative and quantitative methodology for evaluative research which combines understanding, measurement and comparison. Finally, it points to some risks to evidence-based policy which arise from current populism and post-truth politics.

scholarly journals Effect of a Health System–Sponsored Mobile App on Perinatal Health Behaviors: Retrospective Cohort Study (Preprint)

2019 ◽  
Author(s):  
Caroline Cawley ◽  
Hannelore Buckenmeyer ◽  
Trina Jellison ◽  
Joseph B Rinaldi ◽  
Keri B Vartanian
Keyword(s):  
Health Outcomes ◽  
Health System ◽  
Health Information ◽  
Gestational Age ◽  
Infant Care ◽  
Mobile App ◽  
Evidence Based ◽  
Healthy Behaviors ◽  
Behavior Outcomes ◽  
The Impact

BACKGROUND Pregnancy mobile apps are becoming increasingly popular, with parents-to-be seeking information related to their pregnancy and their baby through mobile technology. This increase raises the need for prenatal apps with evidence-based content that is personalized and reliable. Previous studies have looked at whether prenatal apps impact health and behavior outcomes among pregnant and postpartum individuals; however, research has been limited. OBJECTIVE The primary objective of this study is to assess whether the use of a health system–sponsored mobile app—Circle by Providence—aimed at providing personalized and reliable health information on pregnancy, postpartum recovery, and infant care is associated with improved health outcomes and increased healthy behaviors and knowledge among users. METHODS This observational study compared app users and app nonusers using a self-reported survey and electronic medical records. The study took place over 18 months and was conducted at Providence St. Joseph Health in Portland, Oregon. The sample included patients who received prenatal care at one of seven Providence clinics and had a live birth at a Providence hospital. Recruitment occurred on a rolling basis and only those who completed the survey were included. Survey respondents were separated into app users and app nonusers, and survey responses and clinical outcomes were compared across groups using univariate and adjusted multivariate logistic regression. RESULTS A total of 567 participants were enrolled in the study—167 in the app user group and 400 in the nonuser group. We found statistically significant differences between the two groups for certain behavior outcomes: subjects who used the app had 75% greater odds of breastfeeding beyond 6 months postpartum (<i>P</i>=.012), were less likely to miss prenatal appointments (<i>P</i>=.046), and were 50% more likely to exercise 3 or more times a week during pregnancy (<i>P</i>=.04). There were no differences in nutritional measures, including whether they took prenatal vitamins, ate 5 fruits or vegetables a day, or drank caffeine. We found no differences in many of the infant care outcomes; however, there was an increase in awareness of “purple crying.” Finally, there were no significant differences in measured clinical health outcomes, including cesarean births, length of hospital stays (in minutes), low birth weight infants, preterm births, small-for-gestational-age births, large-for-gestational-age births, and neonatal intensive care unit stays. CONCLUSIONS The use of the Circle app, which provides access to personalized and evidence-based health information, was associated with an increase in certain healthy behaviors and health knowledge, although there was no impact on clinical health outcomes. More research is needed to determine the impact of mobile prenatal apps on healthy pregnancies, clinical health outcomes, and infant care.

scholarly journals Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

2021 ◽  
Author(s):  
Andreas Birgegård ◽  
Afrouz Abbaspour ◽  
Stina Borg ◽  
David Clinton ◽  
Emma Forsén Mantilla ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Data Availability ◽  
Evidence Based ◽  
List Type ◽  
Convenience Sample ◽  
Eating Disorder Symptom ◽  
Disorder Symptom ◽  
Evidence Based Care ◽  
The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

scholarly journals COPERNICUS KNOWLEDGE AND INNOVATION HUBS

2020 ◽  
Vol XLIII-B5-2020 ◽  
pp. 35-42
Author(s):  
B. Riedler ◽  
S. Lang ◽  
P. Zeil ◽  
M. Miguel-Lago ◽  
C. Schröder ◽  
...  
Keyword(s):  
Knowledge Exchange ◽  
Data Availability ◽  
Public And Private ◽  
The Public ◽  
Active Involvement ◽  
Free Data ◽  
Financial Framework ◽  
Uptake Process ◽  
The Impact ◽  
And Training

Abstract. Copernicus, the European Space program ensures free data availability and the organisational and financial framework to provide standardized information products in its service domains atmosphere, marine, land monitoring, climate change, emergency management and human security. A key to success to the market uptake process is knowledge exchange among all actors from the various sectors involved, notably research and educational institutions, industry, and the public sector. As a successful instrument to foster and stimulate this exchange, maximize the impact and additionally boost related capacity building and training activities, the Copernicus Academy has been anchored in the European Space Strategy. The present paper highlights some key activities to leverage the potential of this dynamically growing network of experts from universities and research institutions, public and private organizations, companies, stakeholders, and increase the benefit to its members. The vision of establishing both physical implementations of regional Copernicus hubs and virtual Copernicus hubs, built on key elements of the European Innovation strategy, is discussed. Regional hubs, attached e.g. to centres of excellence, are essential to meet local needs for exchange and training to boost the user uptake. The increasing importance of virtual hubs is becoming evident as a critical means to maximise synergies among actors in the rapidly advancing technological areas. Proposed technical elements demonstrate innovative solutions to visualize and facilitate easy harvesting of the Copernicus Academy member´s expertise for different stakeholder and the public, and show cast possibilities of active involvement and exchange within the network.

scholarly journals Confounding in Observational Studies Explained

2012 ◽  
Vol 5 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Bikaramjit Mann ◽  
Evan Wood
Keyword(s):  
Randomized Controlled Trial ◽  
Health Information ◽  
Observational Studies ◽  
Controlled Trial ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Disease Outcomes ◽  
Different Types ◽  
Based Medicine ◽  
The Impact

Practical and ethical constraints mean that many clinical and/or epidemiological questions cannot be answered through the implementation of a randomized controlled trial. Under these circumstances, observational studies are often required to assess relationships between certain exposures and disease outcomes. Unfortunately, observational studies are notoriously vulnerable to the effect of different types of “confounding,” a concept that is often a source of confusion among trainees, clinicians and users of health information. This article discusses the concept of confounding by way of examples and offers a simple guide for assessing the impact of is effects for learners of evidence-based medicine.

scholarly journals Telehealth to support referral management in a universal health system: a before-and-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabrina Dalbosco Gadenz ◽  
Josué Basso ◽  
Patrícia Roberta Berithe Pedrosa de Oliviera ◽  
Stephan Sperling ◽  
Marcus Vinicius Dutra Zuanazzi ◽  
...  
Keyword(s):  
Linear Models ◽  
Patient Flow ◽  
Waiting Times ◽  
Median Number ◽  
Waiting Lists ◽  
Referral Management ◽  
Before And After ◽  
The Impact ◽  
Universal Health ◽  
Before And After Study

Abstract Background Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. Methods Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. Results At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. Conclusions Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.

Using evidence in shaping disability policy in Romania: the case of sheltered workshops

2021 ◽  
Author(s):  
Claudia Petrescu ◽  
Mihaela Lambru
Keyword(s):  
Public Administration ◽  
Disability Policy ◽  
Evidence Based ◽  
Employment Policy ◽  
Persons With Disabilities ◽  
Sheltered Workshops ◽  
Evidence Based Policy ◽  
Work Integration ◽  
Disability Employment ◽  
The Impact

Background: The importance of using evidence to inform the policymaking process has been well established in the literature and practice. In Western countries evidence-based policy (EBP) is already accepted and implemented in many policy areas, including disability policy. In Central and Eastern Europe (CEE) the interest in EBP (evidence-based policy) is new and limited, hampered in many aspects by the regional specificity of the public administration and welfare services reform.Aims and objectives: The present article aims to explore the development of evidence-based disability employment policy in Romania, in a specific area of work integration: sheltered workshops.Methods: The article draws on the findings of extensive research on sheltered workshops that included multiple research methods, such as public policy analysis, social documents analysis, and secondary data analysis of quantitative and qualitative data.Findings: A number of issues concerning the implementation of evidence-based disability policy in Romania have been identified. Some of these issues are related to the administrative and policy capacity of the government. Others are linked to the limitation of the advocacy capacity of Civil Society Organisations (CSOs) active in the disability area, or to the weak presence of the academic/research community in the disability policy forum.Discussion and conclusions: There is a limited knowledge of how evidence-based disability policy is developed in CEE countries. This article will emphasise the role of the sheltered workshops in shaping the policy solutions in the area of work integration for persons with disabilities. The article will contribute to better understanding of the disability policy reform, looking closely at how the evidence is built and used within the disability policy process.<br />Key messages<br /><ul><li>The paper explores pathways of evidence use to support decisions on disability policy in Romania.</li><br /><li>The disability reform in Romania is influenced by Welfare State and Public Administration reform, EU integration process, EU Disability Action Plans (DAPs) and the signing of the UN Convention of Persons with Disabilities.</li><br /><li>The social economy framework has influenced the employment opportunities for persons with disabilities. The sheltered workshops have become an important actor in promoting work integration for people with disability. Also the sheltered workshops have an important role in modernising evidence-based disability employment policy</li><br /><li>The lack of statistical data and relevant knowledge about what works, and the impact on the integration of people with disabilities, is impeding the development of both disability rights and disability services, and has determined the adoption of policy decisions that have profoundly affected work integration in this area.</li></ul>

Minimizing the Impact of Interoperability Errors on Clinicians

2018 ◽  
Vol 7 (1) ◽  
pp. 64-68 ◽  
Author(s):  
Jolie Dobre ◽  
Tippy Carter ◽  
Jennifer Herout ◽  
Amanda Cournoyer
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Aggregate Data ◽  
Data Availability ◽  
Usability Study ◽  
External Sources ◽  
The Impact ◽  
The U.S

There is little guidance in the literature on how health information technology (HIT) interfaces should be designed to inform clinicians of data availability. As the industry focuses on interoperability between systems and devices, and as more HIT products aggregate data from external sources, it becomes increasingly critical to identify methods to alert clinicians of the availability of data without negatively impacting clinician workflow or contributing to alert fatigue. This paper reports on a case study of a usability study done on the U.S. Department of Veteran’s Affairs (VA) Joint Legacy Viewer (JLV) to provide guidance to developers on communication of connection errors and interface status. The issue, process to explore the issue, and findings are discussed. As publicly developed software, the efforts behind VA’s JLV design choices and images of design solutions can be shared to further the field’s understanding.

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