Limited funding has
become a permanent condition for health care systems, and
governments and private payers continue to press all those involved
in the management and provision of care to become more cost-effective.
Concurrently, the volume and (to a lesser extent) the quality of
the health research and HTA literature continues to grow by leaps
and bounds. The movement toward evidence-based medicine, management,
and decision-making is international, and affects governments,
health agencies, practitioners, and researchers.
The BC Ministry of
Health, like governments elsewhere, is asking agencies to assess
program effects on health outcomes, encouraging hospitals
and other agencies to set up committees to regulate and assess new
technologies, and promoting evidence-based medical practice with
guidelines and payment protocols. However, few agencies or practitioners
have much experience with formal assessment of evidence or with
health outcome reporting, most have no nearby source of such
expertise, and only limited support is available from the Ministry
for these new roles. There remains both misunderstanding and misuse
of evidence-based medicine (EBM) and evidence-based decision-making
(EBDM), leading to suspicion by physicians that these methods are
just another means of cutting costs and taking control of
clinical issues out of physicians' hands. Outcome reporting is often
seen as just another unnecessary administrative burden. In fact,
all of these methods, used correctly, can lead to more cost-effective
(but not necessarily cheaper) health care, and a better working
and caregiving environment for patients, providers, and managers.
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