Evidence-based health policy-making, hospital funding and health insurance

An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-ba sed approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various discipli nes involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political as sessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of ev idence on the impact of policy options for improving the health status of t he community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiative s shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by init iatives such as greater exposure of health professionals to educational inp uts with a policy focus; increased contribution of doctors to health servic es research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.