Health Policy Services Research Research Articles

Health Services Policy Research: Uniquely Positioned to Drive Equitable System Transformation.

With the launch of its Strategic Plan 2021-2026, the Canadian Institutes of Health Research - Institute of Health Services Policy Research (IHSPR) has embarked on a formidable quest to secure healthcare's holy grail: health system transformation, health equity and the vaunted pillars of the Quadruple Aim (Bodenheimer and Sinsky 2014; CIHR IHSPR 2021).

VP02 Are Journal Editors A Barrier To Publication Of Real World Evidence?

INTRODUCTION:Health technology assessment (HTA) bodies often rely heavily upon evidence from peer-review publications to inform their recommendations. Since journal editors attitudes likely influence the types of study designs that are accepted through the peer-review process and on to publication, journal editors serve as gatekeepers to translation of evidence, including real word evidence (RWE), into practice. Given past skepticism of RWE study designs, journal editors perceptions of and possible biases toward RWE are important to understand as they may impact dissemination and, therefore, uptake of research findings. The objective of this study was to examine current views of journal editors regarding the: (i) value of RWE studies and (ii) challenges editors face in managing, reviewing, and publishing RWE manuscripts.METHODS:Journal editors representing general medicine (GM), specialty medicine (SM), health policy/services research (HSR) were invited to participate in a telephone interview, a survey, and an in-person, roundtable discussion.RESULTS:In total, seventy-nine journals were approached, resulting in: 15 interviews (GM = 2; SM = 5; HSR = 8), 17 survey responses (GM = 2; SM = 6; HSR = 9) and 8 roundtable participants. RWE was viewed favorably by interviewed editors (n = 15). Characteristics of high-quality RWE manuscripts included: research question novelty/relevance, rigorous methodology, alignment of data with question, and the extent data-source advantages are optimized. Similar manuscript review processes and challenges were voiced for RWE and other study designs. HSR editors were more likely than SM or GM editors to participate, potentially indicating these researchers are more comfortable or interested in RWE. A possible study limitation was that editors favorable toward RWE may have been more likley to participate.CONCLUSIONS:Peer-review journal editors appear to have favorable views regarding RWE studies and can be accelerators to dissemination of RWE findings. However, they do report that studies and processes could be improved. One suggested improvement included a checklist for editors to speed rejections and improve communications with authors.

Health Services & Policy Research in translational medicine.

Translational medicine is often defined through its process. Researchers from different disciplines may see the process differently (Figure 1) (1). Basic scientists and clinicians may describe it as the “bench to bedside” approach of medical research (2). Only a few institutes of translational medicine realize that Health Services & Policy Research (HSPR) is an important component in translational medicine (3,4). Health services & policy researchers can bridge laboratory research, clinical studies, community practice, and health policy to improve public health. Figure 1 Process of translational medicine from different researchers’ perspective. The goal of translational medicine is to translate academic research into population health (5). US National Health Institute launched the Clinical and Translational Science Awards (CTSA) program in 2006 to strengthen the full spectrum of translational research. In 2012, NIH published a summary report based on the stakeholders’ feedback about the CTSA program. Only two vague long-term outcomes were proposed to measure the value added by the CTSA program: increased utilization of new treatments in the community and community health indicators improvement (6). However, the CTSA program has realized that NIH should engage with Center of Medicare and Medicaid Services (CMS) and Agency of Healthcare Research and Quality (AHRQ) to promote HSPR such as comparative effectiveness research and patient centered outcomes research. Basic scientists and clinicians need to work synergistically with health services & policy researchers in the translational process. HSPR in translational medicine is different from the biostatistical support in the current CTSA program. HSPR evaluates effectiveness and cost-effectiveness of the new technology or treatment with observational data and survey data when the new treatment expands discovery to larger patient populations. HSPR employs comparative effectiveness research to determine if a certain treatment or technology works in a real-world setting when the practice-oriented stage of translational research is implemented and find out subgroups of patients who benefit the most (or the least) from the new therapy. If everything was successful, we need to evaluate the current healthcare policy and delivery system to identify barriers to disseminate and implement the new therapy and propose certain policy changes to efficiently reach clinicians and patients. In summary, translational medicine is not just bench to bedside, prototype to device, or beaker to pill. HSPR is an essential component of translational medicine. It is a critical move for Annals of Translational Medicine to create a new HSPR column. This new column will provide a forum for the researches that bridge academic research, health policy, and medical practice. The articles appearing in this column will be authored by scholars from universities, government, private research organizations, and industry. We welcome all submissions that examine how and whether new therapies and research knowledge reach the intended people and are implemented efficiently. The publications from the HSPR column will strengthen communication with practitioners and policymakers and influence medical practice and health policy at all administrative levels.

Evidence-informed primary health care workforce policy: are we asking the right questions?

Australia is facing a primary health care workforce shortage. To inform primary health care (PHC) workforce policy reforms, reflection is required on ways to strengthen the evidence base and its uptake into policy making. In 2008 the Australian Primary Health Care Research Institute funded the Australian Health Workforce Institute to host Professor James Buchan, Queen Margaret University, UK, an expert in health services policy research and health workforce planning. Professor Buchan's visit enabled over forty Australian PHC workforce mid-career and senior researchers and policy stakeholders to be involved in roundtable policy dialogue on issues influencing PHC workforce policy making. Six key thematic questions emerged. (1) What makes PHC workforce planning different? (2) Why does the PHC workforce need to be viewed in a global context? (3) What is the capacity of PHC workforce research? (4) What policy levers exist for PHC workforce planning? (5) What principles can guide PHC workforce planning? (6) What incentives exist to optimise the use of evidence in policy making? The emerging themes need to be discussed within the context of current PHC workforce policy reforms, which are focussed on increasing workforce supply (via education/training programs), changing the skill mix and extending the roles of health workers to meet patient needs. With the Australian government seeking to reform and strengthen the PHC workforce, key questions remain about ways to strengthen the PHC workforce evidence base and its uptake into PHC workforce policy making.