Informed policy making and research evidence

According to the World Health Organisation (WHO) evidence informed policy making aims to ensure that the best available research evidence is used to inform decision making. ¹ Since last year, ‘evidence’ has been at the forefront of daily debate regarding measures to fight the covid-19 pandemic. At times when most policy makers claim to support the use of (research) evidence in decision making, their use of the best available evidence often gets criticked. In researching the quality of public decision, Head has argued that “the potential for close linkage between good information and “good policy making” is routinely undermined by two important mechanisms: political and organizational”. ²

In the light of the political context, evidence is harnessed to competing arguments about ends and means and the political decision-making process is inherently characterised by conflicts, trade-offs, and compromises. With different organizations being involved, the information needs and practices of policy makers in terms of evidence use and information management will vary considerably. ² Furthermore, as Head has pointed out, in contrast to the plethora of policy and program documents produced annually, there has been surprisingly little research concerning how policy workers actually make decisions informed by available evidence and what sources of evidence are actually deployed in this process. ²

To better understand evidence-informed policy making regarding care coordination, the International Journal of Care Coordination welcomes submissions analysing how policy workers on care coordination undertake their policy design and review roles, how they perceive their tasks, how they use different types of information, what sources they trust and why, and how they process the feedback from political leaders and key stakeholders.

The current issue of the International Journal of Care Coordination offers an interesting mixture of papers to inform decision making about care coordination. Milionis et al. discusses the dual role of health care systems when finding themselves at the frontline of the fight against covid-19 and at the same time they must continue to offer emergency and routine health services. Moreover, health care systems need to deal with the conflicting challenges of the simultaneous protection of both universal health coverage and health care efficiency. Milionis et al. argue that allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit. ³

To determine whether depression moderates the relationship between injection drug use and HIV screening among people with substance use, Cody et al. conducted a retrospective cross-sectional study. They found that high risk subgroups such as injection drug users with severe depression may not be using HIV prevention services, leading to possible delays in HIV diagnosis. Hence their recommendation to integrate behavioural interventions and HIV prevention services to reduce risk factors among depressed injection drug users. ⁴

Ofei and Paarima examined the care coordination practices of nurse managers at the unit level among 522 nurses from 19 hospitals in the Greater Accra region of Ghana. By using a regression model, the authors were able to identify the unit, the unit workload, the experience as a nurse manager, and work duration as significant predictors of the behaviour of nurse managers regarding care coordination. ⁵

The final paper by Perman et al. evaluated the effectiveness of an integrated health and social care programme for home-dwelling frail older persons in Buenos Aires, Argentina. Main component of the programme is a health and social care counsellor who systematically reviews the social and biological situation, including functionality, nutrition, mobility, pain, cognition, medication reconciliation and adherence, need for care, quality of care, and environmental safety. From their quasi-experimental study Perman et al. report lower hospital admissions and better quality of life for people in the intervention group. ⁶

Since research evidence itself is insufficient for good policy making, the International Journal of Care Coordination will require future authors to write a separate paragraph about the relevance of study findings from a policy maker’s perspective. Together with a paragraph describing the relevance from a patient’s perspective, a requirement for several years already, the International Journal of Care Coordination aims to challenge authors to help the dissemination of research evidence on care coordination.