Public health interventions tend Essay Example

Public health interventions tend Essay Example Public health interventions tend Paper Public health interventions tend Paper Public health interventions tend to be complex, programmatic and context dependent. The evidence for their effectiveness must be sufficiently comprehensive to encompass that complexity. The question that has been widely asked therefore is whether and to what extent evaluative research on public health interventions can be adequately appraised by applying well established criteria for judging the quality of evidence in clinical practice. It is adduced that these criteria are useful in evaluating some aspects of evidence. However, there are other important aspects of evidence on public health interventions that are not covered by the established criteria and one of these other important aspects of evidence is economic evaluation. Evidence-based health care is intended to take account of efficiency as well as effectiveness, although to date efficiency questions have not been emphasized in evidence-based medicine. The appraisal of evidence on public health interventions must inevitably determine whether efficiency has been assessed, and if so, how well. Examples of these include a guide to common standards so that evaluations from different settings can be compared; checklists for appraising published articles; regulatory guidelines; and ethical principles of good practice in economic evaluations. The evaluation of evidence must distinguish between the fidelity of the evaluation process in detecting the success or failure of an intervention, and the success or failure of the intervention itself. Moreover, if an intervention is unsuccessful, the evidence should help to determine whether the intervention was inherently faulty (that is, failure of intervention concept or theory), or just badly delivered (failure of implementation). Furthermore, proper interpretation of the evidence depends upon the availability of descriptive information on the intervention and its context, so that the transferability of the evidence can be determined. Study design alone is an inadequate marker of evidence quality in public health intervention evaluation. The economic evaluation of healthcare programmes has become more important in recent years and this is reflected by an increase in the literature. It is now an accepted tool for the appraisal of healthcare programmes. Studies may be conducted from the viewpoint of individual recipients of healthcare, healthcare providers or society generally and such investigations are now being undertaken by researchers from many different fields including economists, medical researchers and clinicians. Economic evaluation may be defined as the comparative analysis of alternative courses of action in terms of both their costs and consequences It involves two main areas, first, the costs and consequences of programmes and, second, choices which have to be made in allocation of resources. Although sometimes viewed with suspicion by both clinicians and the general public, economic evaluation does aim to determine how resources can give the greatest benefit.