Translating research findings into health policy
Translating research findings into health policy
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DOI：
10.1016/0277-9536(96)00130-x
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发表时间：
1996-09-01
影响因子：
5.4
通讯作者：
HowdenChapman, P
中科院分区：
文献类型：
--
作者：
Davis, P;HowdenChapman, P
研究对卫生政策的影响的证据是矛盾的。尽管没有足够的证据表明研究对广泛的医疗改革的方向或实施产生了任何影响，但循证医学的研究却急剧增加，尽管证据表明它影响了临床实践。这些发展是在陈旧的干预和供给普遍下降以及对研究人员权威的后现代质疑的背景下发生的。研究与政策之间关系的模型范围广泛，从实证研究通过研究逐步影响政策来理性地为决策提供信息，到可以在概念层面上运作的“启蒙”或“渗透”模型。有助于大规模社会政治变革的健康研究可能需要更多的方法论多元化和更多地关注关键的制度结构。审查的案例研究表明，如果研究人员让管理者和政策制定者参与研究框架和研究重点的制定，并且如果研究人员承担起将他们的研究转化为政策的责任，那么传播就会得到加强。如果公共卫生研究具有针对性、及时性、资金充足并且由包括学者在内的协作团队进行，那么其影响力就会更大。此外，如果评估是由卫生当局委托进行的，但基于当地收集的数据，并且有实施政策的工具和激励措施，那么评估的影响力就会更大。在某些领域，例如最近针对社区护理人员的政策，研究人员在很大程度上负责提出这一政策问题，而在其他领域，例如失业与健康之间的关系，研究人员只是对因果关系提出相互竞争的主张的专家群体之一。总之，明确的研究结果并不总是政策的通行证，但研究人员可以重新构建看待卫生政策问题的方式，并且最初与政策制定者的合作可以加强以后的实施。版权所有 (C) 1996 爱思唯尔科学有限公司
Evidence of the influence of research on health policy is paradoxical. While there is scant evidence that research has had any impact on the direction or implementation of widespread health reforms, research on evidence-based medicine has dramatically increased, despite limited evidence that it has affected clinical practice. These developments have occurred in the context of a general decline in stale intervention and provision and a post-modern questioning of researchers' authority. Models of the relationship between research and policy range from,ne where empirical research rationally informs decision-making, through research incrementally affecting policy, to an ''enlightenment'' or ''infiltration'' model, which may operate on a conceptual level. Health research that contributes to large-scale socio-political change may require more methodological pluralism and greater focus on key institutional structures. Case studies reviewed suggest that dissemination is enhanced if researchers involve managers and policy-makers in the development of the Framework for and focus of research and if investigators assume a responsibility for seeing their research translated into policy. Public health research is more influential if topical, timely, well-funded and carried out by a collaborative team that includes academics. Evaluations are more influential if, in addition, they are commissioned by health authorities but based on local collection of data, and instruments and incentives to implement policy are available. In some areas, such as the recent policy focus on carers in the community, researchers were largely responsible for raising this policy issue, whereas in other areas, such as the relationship between unemployment and health, researchers are just one of the groups of experts making competing claims about causality. in conclusion, clear research findings are not always a passport to policy, but researchers can reframe the way health policy issues are seen, and collaboration with policy-makers initially can enhance implementation later. Copyright (C) 1996 Elsevier Science Ltd.