tailieunhanh - báo cáo khoa học: "Rationality versus reality: the challenges of evidence-based decision making for health policy makers"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Rationality versus reality: the challenges of evidence-based decision making for health policy makers | McCaughey and Bruning Implementation Science 2010 5 39 http content 5 1 39 IMPLEMENTATION SCIENCE Implementation Science DEBATE Open Access Rationality versus reality the challenges of evidence-based decision making for health policy makers Deirdre McCaughey 1 and Nealia S Bruning2 Abstract Background Current healthcare systems have extended the evidence-based medicine EBM approach to health policy and delivery decisions such as access-to-care healthcare funding and health program continuance through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidencebased decision making EBDM and evidence-based policy making EBPM because humans make decisions with their naturally limited faulty and biased decision-making processes. A cognitive information processing framework is presented to support this argument and subtle cognitive processing mechanisms are introduced to support the focal thesis health policy makers decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models the rational choice utility maximizing assumptions in EBDM and EBPM must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive .