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51-407: With advances in computing technology and databases, many more types of public health research , including time-consuming cohort studies , are now possible; sifting through health data is quicker. Medical conditions can be cross-referenced with lifestyle. The GPES began in 2007. The NHS has not had a good record for computer systems. The NHS National Programme for IT, a complete digital overhaul of

102-401: A common approach to help healthcare professionals at an institution learn new skills, keep up with ever-changing clinical practice guidelines, have opportunities for advancing their skills, and create opportunities to connect with peers. Various formats are used including workshops, audits, educational outreach, feedback sessions, lunch-and-learn seminars, and courses. There is a large variety in

153-482: A large effect on long-term health outcomes. The way that GPET-Q did this was queries being built around keys dates and medical Read codes to define the conditions that were being sought for a particular collection of data. As the life-span of the system continued this moved to use SNOMED CT clinical codes as a way of making the extracts more specialised. It is part of the GP Collections of NHS Digital , formerly

204-454: A motive will increase the rate of medical innovation . Those opposed argue that it will do the opposite, because removing the incentive of profit removes incentives to innovate and inhibits new technologies from being developed and utilized. The existence of sound medical research does not necessarily lead to evidence-based policymaking. For example, in South Africa, whose population sets

255-586: A policy. Understood in this sense, there are many categories of health policies, including global health policy, public health policy, mental health policy, health care services policy, insurance policy , personal healthcare policy, pharmaceutical policy , and policies related to public health such as vaccination policy , tobacco control policy or breastfeeding promotion policy. Health policy may also cover topics related to healthcare delivery, for example of financing and provision, access to care, quality of care , and health equity. Health policy also includes

306-430: A program or intervention. Operational policies are the rules, regulations, guidelines, and administrative norms that governments use to translate national laws and policies into programs and services. The policy process encompasses decisions made at a national or decentralized level (including funding decisions) that affect whether and how services are delivered. Thus, attention must be paid to policies at multiple levels of

357-597: A substantial number of national-level registries available to researchers. Many of these are administered by the National Board of Health and Welfare , including comprehensive administrative datasets regarding specialist in-patient and out-patient care, municipal social services, as well as cause of death and drug prescription registries. Over 100 clinically oriented quality registries exist oriented towards an array of specific patient populations and sub-domains. A number of Swedish universities host research groups focusing on

408-969: A web search can find these with relative ease. Claims data on US Medicare and Medicaid beneficiaries are available for analysis. Data is divided into public data available to any entity and research data available only to qualified researchers. The US's Centers for Medicare and Medicaid Services (CMS) delegates some data export functions to a Research Data Assistance Center. 23 Claims data from various states that are not limited to any particular insurer are also available for analysis via AHRQ 's HCUP project. Colloquially, health services research departments are often referred to as "shops"; in contrast to basic science research "labs". Broadly, these shops are hosted by three general types of institutions—government, academic, or non-governmental think tanks or professional societies. Government Sponsored University Sponsored Think Tank or Professional Society Sponsored Health policy Health policy can be defined as

459-409: Is a relatively young science that developed through the bringing together of social science perspectives with the contributions of individuals and institutions engaged in delivering health services. The primary goals of health services research are to identify the most effective ways to organize, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety . HSR

510-478: Is a right of all people: In some jurisdictions and among different faith-based organizations , health policies are influenced by the perceived obligation shaped by religious beliefs to care for those in less favorable circumstances, including the sick. Other jurisdictions and non-governmental organizations draw on the principles of humanism in defining their health policies, asserting the same perceived obligation and enshrined right to health . In recent years,

561-485: Is between levels of analysis: Another distinction can be made between the intent of the research question as either normative/evaluative or exploratory/explanatory. Leadership that includes all members of staff and patients in a healthcare setting is referred to as "collective leadership". The idea is that all people involved in healthcare, including those at the receiving end such as patients and caregivers/families, share responsibility for decision making, performance of

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612-437: Is distributed among labour market participants as a laissez-faire approach to health policy. Evidence-based policies for workforce development are typically based on findings from health services research . Many governments and agencies include a health dimension in their foreign policy in order to achieve global health goals. Promoting health in lower income countries has been seen as instrumental to achieve other goals on

663-466: Is grounded in theory, its underlying aim is to perform research that can be applied by physicians , nurses , health managers and administrators , and other people who make decisions or deliver care in the health care system . For example, the application of epidemiological methods to the study of health services by managers is a type of health services research that can be described as Managerial epidemiology . A common distinction of approaches to HSR

714-670: Is growing. The main goal is to improve performance of healthcare. Performance-based payment (P4P) is one approach that has been studied. Performance-based payment is a broad approach that includes the concept of offering financial incentives if specific targets are met. Many data and information sources are used to conduct health services research, such as population and health surveys, clinical administrative records, health care program and financial administrative records, vital statistics records (births and deaths), and other special studies. Several government, academic and non-government agencies conduct or sponsor health services research, notably

765-578: Is left to the individual to gain access to healthcare goods and services by paying for them directly as out-of-pocket expenses , and to private sector players in the medical and pharmaceutical industries to develop research. Planning and production of health human resources is distributed among labour market participants. Other countries have an explicit policy to ensure and support access for all of its citizens, to fund health research, and to plan for adequate numbers, distribution and quality of health workers to meet healthcare goals. Many governments around

816-513: Is more concerned with delivery and high quality access to care, in contrast to medical research, which focuses on the development and evaluation of clinical treatments. Health services researchers come from a variety of specializations, including geography , nursing , economics , political science , epidemiology , public health , medicine , biostatistics , operations , management , engineering , pharmacy , psychology , usability and user experience design . While health services research

867-576: Is ongoing on which type of health financing policy results in better or worse quality of healthcare services provided, and how to ensure allocated funds are used effectively, efficiently and equitably . There are many arguments on both sides of the issue of public versus private health financing policies: Claims that publicly funded healthcare improves the quality and efficiency of personal health care delivery: Claims that privately funded healthcare leads to greater quality and efficiencies in personal health care: Health policy options extend beyond

918-433: Is weak evidence to suggest that educational meetings may help healthcare staff change their practices to comply with changes or desired practices more than other approaches to encourage change including emails, text messages, or fees. Research looking into the quality of healthcare in low and middle income countries and different approaches to improving performance of healthcare delivery in countries with resource constraints

969-783: The Canadian Institute for Health Information and the Canadian Institutes of Health Research (i.e. the third pillar: "research respecting health systems and services"). Others include the Institute for Clinical Evaluative Sciences (ICES) for the province of Ontario, and the Canadian Collaborative Study of Hip Fractures . Several registries are available for research use, such as Danish Twin Register or Danish Cancer Register. Public Health Research Laboratory. Sweden has

1020-466: The European Commission and national governments debate strategic health concerns. The EU's health policy and yearly work programmes are implemented with the assistance of member states, institutions, and other interest groups. The European Commission's Directorate for Health and Food Safety assists member states in their efforts to protect and improve the health of their people and to guarantee

1071-810: The authorisation of medicines at EU level by the European Medicines Agency or at the national level by the appropriate authorities in the EU member states. To guarantee a high degree of health protection in the European Union, monitoring, early warning, preparedness, and reaction measures to counter major cross-border threats to health are crucial. The European Centre for Disease Prevention and Control (ECDC) offers EU member states independent scientific advice, support, and knowledge on public health risks, including infectious diseases. The EU4Health program provides funds to tackle cross-border health concerns, improve

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1122-490: The "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization , an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people. Health policy often refers to the health-related content of

1173-467: The 1960s, when scientific information and policy deliberation began to coalesce. Sometimes also referred to as health systems research or health policy and systems research ( HPSR ), HSR is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. HSR utilizes all qualitative and quantitative methods across

1224-433: The EU can also send recommendations on public health to member states. EU citizens are entitled, by law , to receive healthcare in any member state of the EU and to have their home nation compensate them for care received elsewhere. The European Health Insurance Card (EHIC) guarantees that essential medical care is given under the same conditions and at the same cost as people insured in that country. The EU regulates

1275-768: The Health Services Research, including the Karolinska institute, Lund University, and Uppsala University. Several governmental agencies exist that sponsor or support HSR, with their remits set by central and devolved governments. These include the National Institute for Health and Care Research (NIHR) and its constituent infrastructure (including the CLAHRC programme); Healthcare Improvement Scotland ; Health and Care Research Wales ; and Health and Social Care Research and Development. Many universities have HSR units,

1326-494: The Health Union. The goals of EU public health policies and initiatives are to protect and improve the health of EU residents , promote the modernization and digitalization of health systems and infrastructure, increase the resilience of Europe's health systems, and improve the ability of EU member states to prevent and respond to pandemics in the future. In a senior-level working group on public health, representatives from

1377-680: The Health and Social Care Information Centre or HSCIC. Another part is the Calculating Quality Reporting Service (CQRS). Other similar UK databases include the Clinical Practice Research Datalink and The Health Improvement Network . It pursues similar work to UK public health observatories . Health services research Health services research ( HSR ) became a burgeoning field in North America in

1428-582: The NHS's medical records, became NHS Connecting for Health , and then partly by the Health and Social Care Information Centre; a lot of money was effectively lost on NHS Connecting for Health, sometimes quoted at £12 billion. GPES was meant to cost £14m but has cost £40m. The system was discussed by the Public Accounts Committee (PAC) in 2015, who said the system has begun five years later than planned, being planned to start in 2009. During its usage period,

1479-936: The accessibility, efficiency, and resilience of their healthcare structures. This is accomplished in a number of ways, such as by proposing legislation , providing financial support , coordinating and facilitating the exchange of best practices between EU countries and health experts and by health promotion activities. The Treaty on the Functioning of the European Union grants the EU the authority to enact health legislation in accordance with Article 168 (protection of public health), Article 114 (single market), and Article 153 (social policy). The EU has adopted legislation in following areas: Patient's rights in cross-border healthcare, Pharmaceuticals and medical devices (pharmacovigilance, falsified medicines, clinical trials), Health security and infectious diseases, Digital health and care, Tobacco, organs, blood, tissues and cells. The Council of

1530-505: The actors and norms that frame the global health response. The EU contributes to the improvement of public health through financing and laws addressing medications, patient rights in cross-border healthcare, illness prevention, and the promotion of good health. EU countries hold primary responsibility for organizing and delivering health services and medical care. Therefore, EU health policy works to supplement national policies, assure health protection in all EU measures and to strengthen

1581-790: The best interests of their customers compared to government regulation and oversight. Another claim in the United States perceives government over-regulation of the healthcare and insurance industries as the effective end of charitable home visits from doctors among the poor and elderly. Many types of health policies exist focusing on the financing of healthcare services to spread the economic risks of ill health. These include publicly funded health care (through taxation or insurance, also known as single-payer systems), mandatory or voluntary private health insurance , and complete capitalization of personal health care services through private companies, and medical savings accounts , among others. The debate

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1632-438: The board to ask questions of the healthcare system. It focuses on performance, quality , effectiveness and efficiency of health care services as they relate to health problems of individuals and populations, as well as health care systems and addresses wide-ranging topics of structure, processes, and organization of health care services; their use and people's access to services; efficiency and effectiveness of health care services;

1683-453: The case in Canada's national health insurance program . Laissez-faire supporters argue that this erodes the cost-effectiveness of the health system, as even those who can afford to pay for private healthcare services drain resources from the public system. The issue here is whether investor-owned medical insurance companies or health maintenance organizations are in a better position to act in

1734-455: The case of Brazil, where debates have arisen over government policy authorizing the domestic manufacture of antiretroviral drugs used in the treatment of HIV/AIDS in violation of drug patents . Some countries and jurisdictions have an explicit policy or strategy to plan for adequate numbers, distribution and quality of health workers to meet healthcare goals, such as to address physician and nursing shortages . Elsewhere, workforce planning

1785-423: The costs of medical care for all people and under what circumstances. For example, government spending on healthcare is sometimes used as a global indicator of a government's commitment to the health of its people. On the other hand, one school of thought emerging from the United States rejects the notion of health care financing through taxpayer funding as incompatible with the (considered no less important) right of

1836-401: The efficiency of health care delivery and minimize costs. The modern concept of healthcare involves access to medical professionals from various fields as well as medical technology , such as medications and surgical equipment . It also involves access to the latest information and evidence from research, including medical research and health services research . In many countries it

1887-442: The financing and delivery of personal health care, to domains such as medical research and health workforce planning, both domestically and internationally. Medical research can be both the basis for defining evidence-based health policy, and the subject of health policy itself, particularly in terms of its sources of funding. Those in favor of government policies for publicly funded medical research posit that removing profit as

1938-548: The global agenda, including: Global health policy encompasses the global governance structures that create the policies underlying public health throughout the world. In addressing global health, global health policy "implies consideration of the health needs of the people of the whole planet above the concerns of particular nations." Distinguished from both international health policy (agreements among sovereign states) and comparative health policy (analysis of health policy across states), global health policy institutions consist of

1989-421: The governance and implementation of health-related policy, sometimes referred to as health governance, health systems governance or healthcare governance. Conceptual models can help show the flow from health-related policy development to health-related policy and program implementation and to health systems and health outcomes. Policy should be understood as more than a national law or health policy that supports

2040-864: The health system and over time to ensure sustainable scale-up. A supportive policy environment will facilitate the scale-up of health interventions. There are many aspects of politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific policy. Evidence-based policy relies on the use of science and rigorous studies such as randomized controlled trials to identify programs and practices capable of improving policy relevant outcomes. Most political debates surround personal health care policies, especially those that seek to reform healthcare delivery , and can typically be categorized as either philosophical or economic . Philosophical debates center around questions about individual rights , ethics and government authority, while economic topics include how to maximize

2091-548: The healthcare system, and successes. Collective leadership is based on the concept that all stakeholders share viewpoints and knowledge in order to keep up with rapid technological changes, patient-centered outcomes, and the increasing need for specialization in healthcare. The effectiveness of this approach is still being understood and there is no strong evidence to suggest that this approach improves clinical performance, mortality of inpatients, or other outcomes such as staff absences. Medical conferences and educational meetings are

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2142-430: The inclusion criteria, number of people participating in these sessions, type of interactions (for example, passive seminar or hands-on learning experience), frequency of these opportunities, costs, and learning goals. Research into the effectiveness of these approaches is not strong. Educational meetings may slightly improve professional practice and may have a very small improvement on patient outcomes. In addition, there

2193-537: The physician's professional judgment, and the related concerns that government involvement in overseeing the health of its citizens could erode the right to privacy between doctors and patients. The argument furthers that universal health insurance denies the right of individual patients to dispose of their own income as per their own will. Another issue in the rights debate is governments' use of legislation to control competition among private medical insurance providers against national social insurance systems, such as

2244-470: The quality of healthcare services and its relationship to health status, and; the uses of medical knowledge. Studies in HSR investigate how social factors, health policy , financing systems, organizational structures and processes, medical technology , and personal behaviors affect access to health care , the quality and cost of health care, and quantity and quality of life . Compared with medical research , HSR

2295-571: The query tool GPET-Q, and the extraction tool GPET-E. GPET-Q is designed by Paris-based Atos , a large IT services company. The data extracted from the GPES database will help medical research in the United Kingdom, and possible disease prevention at an individual level and at the public level—such as health campaigns. It will find where diseases are prevalent, and in which age groups and geographic areas, and possibly which social class. Social class has

2346-424: The record for HIV infections , previous government policy limiting funding and access for AIDS treatments met with strong controversy given its basis on a refusal to accept scientific evidence on the means of transmission. A change of government eventually led to a change in policy, with new policies implemented for widespread access to HIV services. Another issue relates to intellectual property , as illustrated by

2397-498: The system supported national extracts for NHS England and Public Health England, that not only enabled payment for General Practices. But added to data sets around such areas as Learning Disabilities Observatory. By 2018, the GPET-Q engine was already seen as unfit for use and was beginning to be deprecated, favoring a much simpler system built in house at NHS Digital . Numerous fails of standard Disaster Recovery tests, showed that GPET-Q

2448-446: The world have established universal health care , which takes the burden of healthcare expenses off of private businesses or individuals through pooling of financial risk. There are a variety of arguments for and against universal healthcare and related health policies. Healthcare is an important part of health systems and therefore it often accounts for one of the largest areas of spending for both governments and individuals all over

2499-485: The world. Many countries and jurisdictions integrate a human rights philosophy in directing their healthcare policies. The World Health Organization reports that every country in the world is party to at least one human rights treaty that addresses health-related rights, including the right to health as well as other rights that relate to conditions necessary for good health. The United Nations ' Universal Declaration of Human Rights (UDHR) asserts that medical care

2550-482: The worldwide human rights organization Amnesty International has focused on health as a human right, addressing inadequate access to HIV drugs and women's sexual and reproductive rights including wide disparities in maternal mortality within and across countries. Such increasing attention to health as a basic human right has been welcomed by the leading medical journal The Lancet . There remains considerable controversy regarding policies on who would be paying

2601-508: Was becoming further unstable. By 2020, GPET-Q had been entirely retired, yet NHS Digital continue to receive requests for data extracts that are fulfilled by NHS Digital. The General Practice Data for Planning and Research initiative, announced in May 2021, is intended to replace it. The purpose of the GPES is not dissimilar to the Office for National Statistics in how it collates data. It consists of

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