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Author Hodgetts, Katherine ♦ Elshaug, Adam G. ♦ Hiller, Janet E.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Sociology & anthropology ♦ Economics ♦ Microeconomics & related topics ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Therapeutics ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Health Occupations ♦ Physical Sciences ♦ Social Sciences ♦ Anthropology, Education, Sociology and Social Phenomena ♦ Persons ♦ Persons ♦ Health Care Economics and Organizations ♦ Health Care ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Medicine ♦ Evidence-based Medicine ♦ Health Policy ♦ Physicians ♦ Psychology ♦ Reproductive Techniques, Assisted ♦ Economics ♦ Australia ♦ Female ♦ Humans ♦ Male ♦ National Health Programs ♦ Journal Article ♦ Research Support, Non-u.s. Gov't
Abstract Internationally, there is an increasing focus on quality and sustainability measures oriented to reducing inefficiencies in health provision. The use of assisted reproductive technologies (ART) for older women represents a case study in this area. This paper analyses the constructions of evidence brought to bear by ART physicians in the context of deliberative stakeholder engagements (held 2010) around options for restricting public subsidy of ART in Australia. Physicians participated in two deliberative engagements during which they were presented with results of a systematic review of ART effectiveness, as well as ethical and cost analyses. These sessions were part of a broader research program of engagements held with policymakers, community members and consumers. Physicians deliberated around the data presented with a view to formulating an informed contribution to policy. The ensuing discussions were transcribed and subject to discourse analysis. Physicians questioned the evidence presented on the grounds of 'currency', 'proximity', 'selectivity' and 'bias'. We outline physicians' accounts of what should count as evidence informing ART policy, and how this evidence should be counted. These accounts reflect implicit decisions around both the inclusion of evidence (selection) and the status it is accorded (evaluation). Our analysis suggests that participatory policy processes do not represent the simple task of assessing the quality/effectiveness of a given technology against self-evident criteria. Rather, these processes involve the negotiation of different orders of evidence (empirical, contextual and anecdotal), indicating a need for higher-level discussion around 'what counts and how to count it' when making disinvestment decisions.
Spatial Coverage Australia
Description Country affiliation: Australia
Author Affiliation: Hodgetts K ( School of Population Health and Clinical Practice, The University of Adelaide, North Terrace, Adelaide 5005, SA, Australia.)
ISSN 02779536
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2012-12-01
Publisher Place Great Britain (UK)
e-ISSN 18735347
Journal Social Science & Medicine
Volume Number 75
Issue Number 12


Source: WHO-Global Index Medicus