PHE 5005 week 3 Evidence-based research

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Evidence-Based Research




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Evidence-based research

It is not brainer that research and healthy policy should go hand in hand because there is a very clear connection that exists between the two. Research is not rigorous and straightforward and can help in not only shaping short-term change but long term progress. This obvious connection has not been appreciated by all due competing interests and contrasting priorities have frustrated efforts of translating research into actionable policy.

There are several example of evidence based research can be translated into polices. For instance, Spatz et al (2012) not only did research on barriers to accessing specialty care but went ahead to translate the research into actionable points and policy based solution to addressing those barriers. They describe the formation of team in New Haven that worked Project Access; comprising of researches, health care providers and advocates to identify and overcome challenges to access of specialty care. This partnership was formed on the principles of community-based participatory research, various specialty providers and numerous hospitals were involved in this partnership that resulted in funding for special care and formulation and modification of policies in the local health care system to facilitate access.

Another example that is similar to the above is the partnership between the University of California-Los Angeles and the Los Angeles emergency medical service agency (Grudzen et al, .2012). The partnership developed against the backdrop of research by the university that stated the emergency medical agency staff were performing resuscitation on all patients even resuscitation may not be of any help to them or where the patients has a different preference or where there is danger of physical harm to the patient. To put the research into actionable policy some specific indicators were developed that entailed issues such as asking family members or honoring written or verbal requests against resuscitation.

However, Pollack et al. (2012) points out a different story from the community by examining various practice patterns by different urologists. He combined the cancer registry data Medicare data. He found out that different communities use different patterns but when a patient receives care from a given physician or group of physicians he becomes part of that community whether he knows it or not. This distinct patterns by various urologists affect populations that use this services and payers such as Medicare. This differences that exist among various providers bring into sharp question the need for standardization of clinical approaches

On the other hand, evidence-based research has been known to have influence on health policy even at the national level. For instance, value-based insurance design (VBID) is based on price elasticity and demand; it holds that utilization of a service is inversely related to the cost of that service (Fendrick et al.2012). They observed that service such as VBID that are targeting many insured patients should have incentives to make them more successive such as by reducing out- of pocket expenses while those service that are less effective the cost should go higher to discourage patients. To promote uptake of this research and translate it into policy Fendrick et al.(2012) observes that there is need for continued engagement and interaction between purchasers and policy makers. There is also need to promote and explain the concept to many people so that it can be taken up. The research bore some fruit because as early as 2008 almost 30% of employers were using some form of VBID that culminated in it being incorporated into the national policy by being enshrined in the People’s protection and Affordable Care Act (PPACA).

Downey et al. (2012) on the other hand targets the inpatient safety indicators and how the standards of health have changed over the years between 1998 to 2009.Over this period of time there are some an unprecedented changes that were witnessed in the health sector especially as it related to enhancing the safety of patients. Downey et al. (2012) analyzed more than 69 million hospitalizations and they found that although there were remarkable improvements but also worsening measures were identified. This research proves that although progress has been made to ensure that inpatients are safe but this should not be a reason for complacency. The formulators of health policy need to use this research to identify those areas that have not been completely addressed that be a causes for alarm as far inpatients’ safety is concerned and work toward developing measures to address those concerns.

Coker, Kaplan and Chung (2012) looking at the issue of childhood cancer that has implications both at the national policy level as it relates to insurance coverage and clinical level as it concerns the practice patterns. Their research focused on how insurance cover and quality of asthma care are concerned as it relates to diagnosis and controller medications and their appropriateness. They found out that children have severe cases of asthma are more likely to have some form of insurance coverage compared to children with mild forms of asthma.

A policy implemented in 2010 by National Collegiate and Athletics Association(NCAA) to have all Division 1 players to be screened of sickle cell anemia trait prompted Tarini et al. (20120 to carry out a study to examine this policy. The policy was implemented against prior research about screening of the sickle cell trait. The concerns were that the policy might not help the students but could lead to further discrimination while proponents of the policy held that it will help to identify students in danger of life long health risks. The focused on the concerns raised by those opposed to the policy and the views of the proponents of the policy so that t help the NCAA make an informed decision.


Coker, T. R., R. Kaplan, and P. Chung. 2012.The Association of Health Insurance

and Disease Impairment with Reported Asthma Prevalence in U.S. Children.”

Health Services Research 47 (1, part II): 425–439

Davis, M. M., Gross, C. P., & Clancy, C. M. (2012). Building a bridge to somewhere better: Linking health care research and health policy. Health Services Research, 47(1pt2), 329–336.

Downey, J., T. M. Hernandez-Boussard, G. Banka, and J. M. Morton. 2012. Is Patient

Safety Improving? National Trends in Patient Safety Indicators: 1998-2007.”

Health Services Research 47 (1, part II): 408–424.

Fendrick, A. M., A. E. Weiss, and J. J. Martin. 2012. Value-Based Insurance Design:

MoreHealth at Any Price.” Health Services Research 47 (1, part II): 398–407.

Grudzen, C., L. D. Richardson, W. J. Koenig, J. R. Hoffman, K. A. Lorenz, and S. M.

Asch. 2012.Translation of Evidence-Based Clinical Standards into a New Prehospital

Reususcitation Policy in Los Angeles County.” Health Services Research

47 (1, part II): 363–373.

Spatz, E. S., M. S. Phipps, O. J. Wang, G. I. Lucas, S. Lagarde, L. A. Curry, and M. S.

Rosenthal. 2012. Expanding the Safety net of Specialty Care for the Uninsured:

A Case Study.Health Services Research 47 (1, part II): 344–362.

Tarini, B. A., M. A. Brooks, and D. G. Bundy. 2012. A Policy Impact Analysis of the

Mandatory NCAA Sickle Cell Trait Screening Program. Health Services Research

47 (1, part II): 440–455.

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