Literature Review on "Policy Analysis in Health Care"

Literature Review 12 pages (3285 words) Sources: 20

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Policy Analysis

Issues in Healthcare Policy Analysis: Current Standings, Theoretical Implications, and Impacts on Care: A Literature Review

An issue of increasing public attention and governmental concern for all nations in the modern era is healthcare policy -- how healthcare should be distributed, regulated, and paid for, to be specific. While the central issues of healthcare policy can be stated quite simply, though, actually contending with these issues and creating effective healthcare policy that properly cares for the needs of a given nation's citizens is a far more complex and difficult task. The many different considerations of finances, health outcomes, and ethical principles along with the ever-present problem of how to provide the best balance of services using limited resources make for heated debates and often unclear outcomes, creating political division and worsening practical situations at least as often as they lead to greater cohesion and access to appropriate and affordable care. Developing more effective means of healthcare policy analysis and thus more useful information in the actual development and implementation of healthcare policy is necessary to help the world meet this ongoing problem.

It is all but impossible to approach healthcare policy analysis from a research and practice perspective without engaging to some degree with the political and the philosophical, as any stance on healthcare policy necessarily rests on certain ethical (i.e. philosophical) and thus political assumptions. Attempting to attain true objectivity in healthcare policy analysis is necessary even if it is doomed to ultimate failure, however, as it is through striving to reach this objectivity and the foundational, empirical truths of healthcare provision, healthcare financing, and overall healthcare policy that the perspectives of any principles or political beliefs can be most effectively put to action. The source in addition to the internal integrity of data becomes an important consideration in issues of healthcare policy analysis and development, then, with a broad range of sources and input serving to most comprehensively and accurately identify trends and relevant data. While ideological perspective is not frequently stated or even implicitly evoked in substantive research and literature on the topic, nor should it be, ensuring that a broad range of perspectives are included in any assessment of healthcare policy is a relatively straightforward process of seeking out international and regional studies that represent varying positions in society and the global geopolitical structure, whether or not these positions are seen to impact the research findings and results. Simply put, a broad and multi-faceted review of current literature is an essential starting place for any deeper or more detailed investigation of healthcare policy analysis, development, or implementation scenario.

The following literature review attempts to provide just such a broad and comprehensive understanding of healthcare policy, dividing the specific pieces of literature examined into three broad categories: an assessment of the current standing of healthcare policy analysis and healthcare policy as they are currently employed, an identification of current theoretical advances and problems in ongoing healthcare policy analysis research, and an investigation of the intersection between healthcare policy and real health outcomes in a variety of settings. Through this literature review, a detailed yet comprehensive understanding of current issues in healthcare policy analysis can be obtained and utilized as a foundation for more specific research inquiries, eventually leading to more informed healthcare policy decisions. Information from studies conducted in and/or with a variety of nations and populations and representing a wide range of perspectives form the past decade of research and theoretical commentary have been included in this review in an attempt to ensure real validity and applicability of the information provided by the review, though specific conclusions beyond the concrete factual details and theoretical assertions presented in the literature (such as they exist) are assiduously avoided. This explicit attempt to refrain from any conclusions or judgments will hopefully ensure greater objectivity and a more fair assessment of the research presented, as an unbiased understanding and application of healthcare policy knowledge is desperately needed in the modern world.

Literature Review

The Current State of Healthcare Policy Analysis

An effective overview of the current position of healthcare policy analysis in general and the U.S. healthcare system in particular is provided by Aday (2012). Though the author does not present any original research in this text the research that is provided is given against a background that clearly explains the theoretical en ethical divides inherent to healthcare examinations while also providing extensive knowledge of the facts that exist on-the-ground in the United States (Aday, 2012). The variance between research methodologies and the often disparate or even conflicting findings that can be generated by patient-centric vs. provider-centric research is an especially compelling and noteworthy observation made here, though it is also not firmly established nor is their evidence regarding which way(s) any bias might slant (Aday, 2012). An overall picture of healthcare policy analysis emerges from Aday's (2012) text that is in need of greater cohesion but is trending towards ever-more disparate and polarized opinions and assertions.

Attempts to address this ongoing issue of subjectivity and a lack of cohesive frameworks for the discussion and analysis of healthcare policy include that made by Wendt et al. (2009), in which the authors developed a conceptual framework for typifying and classifying healthcare systems and tracking changes in their parameters and types over time. This is but part of a larger trend in current research to define more objective metrics and instruments by which healthcare policy issues can be addressed, yet Wendt et al.'s (2009) system is one of the more extensive and detailed to be developed. The validity of this system is still questionable, as no use of the framework outside of its development by the researchers and the validity testing these researchers have themselves performed can be found, however ongoing research would do well to utilize this framework and altering it or dismantling it as need be, the results of which would in any case yield more substantive results. At the same time, the number of healthcare system types identified by these authors is large enough to be prohibitive and is indicative of the extreme complexity and variety of factors impacting healthcare policy formation and analysis and the widely varied solutions that currently address these problems in countries around the globe (Wendt et al., 2009).

The modern era has not only brought with it complexity and conflict, however; it has also brought with it an extensive amount of information. Technological advances that have increased information storage, communication, and analysis capabilities have led to "information rich environments" of interconnected agencies, research bodies, and other related groups that can more effectively, efficiently, and accurately investigate and address healthcare policy issues (Roos & Currie, 2004). This study also found that locale and national perspectives/pressures also influenced the manner in which research was conducted, with Canadian information rich research centers producing more work that focused on the economic balance between physician practice patterns and evidenced-based practice (Roos & Currie, 2004). The researchers attribute this to the relationship between Canadian researchers and both national and provincial health ministries that provide research funding, though other factors of influence are also identified and could be replicated (Roos & Currie, 2004).

Modern information gathering and analysis techniques can also be used in more objective ways that are less subject to human influence based on funding source. Data mining algorithms that can assess the efficacy of various complex policy arrangements based on patient health outcomes have been a reality (if an underutilized one) for some time, and are continuing to become more sophisticated and more accurately predictive each year (Chae et al., 2001). These researchers focused on a specific algorithm related to cardiac policy and outcomes, but implications for larger and more general healthcare data mining potentials are made clear (Chae et al., 2001). Dealing with the issues of the modern era requires a utilization of modern tools, and data mining capabilities provide substantial power for healthcare policy analysis.

More research emerging from Canada suggests that in addition to modern informational processing advantages, the modern era is equipped with greater objectivity and broader acceptance of a variety of values that can and should be brought to bear on issues of healthcare policy analysis (Giacomini et al., 2004). The number of different and at times seemingly oppositional values that have been identified in regards to healthcare policy analysis create significant complexities and some barriers to further research, just as the multitude of healthcare system types identified by Wendt et al. (2009), yet they also provide many opportunities for further refining inquiries and creating new frameworks for understanding the manner in which healthcare policy issues are perceived (Giacomini et al., 2004). The authors call for an increasing attention to values not in adjusting results but in defining parameters for the ongoing study and analysis of healthcare policy (Giacomini et al., 2004).

Harrington and Estes (2008) move away from an examination of abstract values and towards an identification of the concrete problem underlying the healthcare policy "crisis" that they perceive: the… READ MORE

How to Reference "Policy Analysis in Health Care" Literature Review in a Bibliography

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