Using Comparative Effectiveness Research To Examine And Improve Health Care Reform

Using Comparative Effectiveness Research To Examine And Improve Health Care Reform

Our understanding of the effectiveness of healthcare interventions continues to pullulate - in particular, our understanding of the impact of related interventions on individuals with mental disorder and substance use disorders is becoming more robust. And yet, research evidence indicates that the realities of care delivery don ' t always equivalent manifest clinical guidelines. In the light of state budget cuts and other financial considerations, efforts are underway to realign direct care practices and clinical guidelines as one of several means to control healthcare costs and improve overall quality of care.
For the first time, significant amounts of money are being allocated to the federal government to evaluate the effectiveness of our nation ' s healthcare. The economic stimulus bill approved by the U. S. Congress in February, 2009 provides $700 million to federal agencies to conduct or support Comparative Effectiveness Research. Congress characterizes CER as research that compares the clinical outcomes, effectiveness, and good of items, services, and procedures that are used to prevent, pinpoint, or treat diseases, disorders and other health conditions.
The Patient Protection and Affordable Care Act establishes an independent CER entity, the Patient Centered Outcomes Research Institute. CER is being embraced by public and private healthcare stakeholders as a leading solution to rising healthcare costs, empty-handed quality, and safety concerns.
Despite this recognition, many healthcare stakeholders remain apprehensive about the impact of CER. In actuality, while the national healthcare reform bill creates a new federal CER entity, it does not authorize its findings to be used to make decisions about the coverage or reimbursement of services. Clinical guidelines steady by financial incentives might become uncontrollable tools, curtail treatment choice, and undermine recovery for a group of clients with very manifold, co - dismal mental and authentic health conditions.
A recent study in a major health monthly reveals that the general public may appraisal other considerations - for example, recommendations from family and friends - more highly than findings from CER. Corresponding veiled value judgments are at odds with the underpinnings of CER; distinctly, fresh efforts must be undertaken to achieve consumer buy - in of the appraisal of CER in their arbitration - making process.
Healthcare advocates are calling for bright language that would prevent the use of CER to deny healthcare recipients needed treatments and therapies. Evidence should assailing quality oracle - making by the provider and the client. Cost is a thing after conspicuous options most true to the individual. CER should support individualized care and not order " one - size fits - all " treatment.
As bipartisan congressional working continues to shape how equivalent and quality are primary in healthcare, there are fine bag steps that researchers and providers need to take:
- Galvanize Congress and the federal government to fresh examine important issues, corresponding as population versus individual applications of make out - based medicine, strain in generating make evident used by policymakers, and definite knowledge of establish gaps and uncertainties. CER must consider a unfathomable spread of try that includes observational studies, disease registry data, and expert opinions stressed from clinical guidelines.
- As federal agencies develop their research agenda, it ' s fundamental that providers consent in the development, translation, and dissemination of research findings into policy and practice. The application of research findings within complicated healthcare systems requires heavier interaction between researchers and users to show a way for adaption and implementation of research results.
- Examine how we effectively demonstrate research into everyday public health policies and programs. Previous efforts to expedite the translation of research into practice often fail to characterize the scholarship gap between evidence - based interventions and effective delivery and adoption by assorted healthcare delivery systems. We must be diligent in articulating the need to support practice - based research in relativity with dissemination of comparative research.
Any CER efforts must be publicly chrgeable. All stakeholders, including clients and providers, can play an active role in the entire research process from setting research priorities to disseminating research results. Greater focus is needed for identifying the best methods to have clients in translating, disseminating, and implementing evidence to protect that research is useful for policymaking.