Journal of health services research & policy
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J Health Serv Res Policy · Oct 2002
ReviewHealth policy-makers' perceptions of their use of evidence: a systematic review.
The empirical basis for theories and common wisdom regarding how to improve appropriate use of research evidence in policy decisions is unclear. One source of empirical evidence is interview studies with policy-makers. The aim of this systematic review was to summarise the evidence from interview studies of facilitators of, and barriers to, the use of research evidence by health policy-makers. ⋯ Interview studies with health policy-makers provide only limited support for commonly held beliefs about facilitators of, and barriers to, their use of evidence, and raise questions about commonsense proposals for improving the use of research for policy decisions. Two-way personal communication, the most common suggestion, may improve the appropriate use of research evidence, but it might also promote selective (inappropriate) use of research evidence.
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J Health Serv Res Policy · Oct 2002
Randomized Controlled Trial Clinical TrialEvaluation of a complex intervention for changing professional behaviour: the Evidence Based Out Reach (EBOR) Trial.
To identify the effect of a complex intervention (educational outreach visits by pharmacists) designed to change general practitioners' (GPs') prescribing on each step of a hypothesised pathway of change leading to the final primary trial outcome of change in prescribing. ⋯ Although our study is limited by a post hoc rather than a pre hoc design, it provides a pragmatic approach to understanding the factors influencing the pathway of change in prescribing behaviour in response to academic outreach visits.
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J Health Serv Res Policy · Jul 2002
Multiple sclerosis and quality of life: a qualitative investigation.
Many people who live with long-term illness experience a decline in their quality of life. The primary aim of this qualitative study was to identify aspects of life that contributed to the quality of the lives of people who had one particular chronic illness, namely multiple sclerosis (MS). A secondary aim was to use this information to highlight areas where there was potential for effective intervention by health or social services. ⋯ Many aspects of living with chronic illness are unavoidable, but health or social intervention can affect others. Inappropriate personal assistance may result in dependency, which detracts from personal control and worsens quality of life. When appropriate, however, support may have beneficial consequences. By recognising the specific factors that link personal control and the illness trajectory, appropriate and timely support can be negotiated.
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J Health Serv Res Policy · Jul 2002
Variations in practice admission rates: the policy relevance of regression standardisation.
To explore variations in general practice admission rates, comparing standardisation by regression with direct standardisation of the data to identify explained and unexplained variation. ⋯ Given the increasing importance of systematic performance assessment to support quality improvement, care must be taken when interpreting variations in health care activity even after conventional standardisation of the data. If significant variations are detected, regression analysis can assist in explaining some of it, which is the starting point in informing discussions about whether variations are justified or unjustified.
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J Health Serv Res Policy · Jul 2002
ReviewSystematic review of outreach clinics in primary care in the UK.
To determine the benefits of holding specialist outreach clinics in primary care settings by means of a systematic literature review of UK studies. ⋯ Health care purchasers and providers must decide whether the advantages in terms of patients' experience of outreach clinics are worth the additional costs. They also need to consider issues of equity, which have not been addressed in research to date.