Association for Public Policy Analysis & Management

Background: The debate on the use of economic evidence in decision making has evolved significantly and evidence-based practices are now considered to be main stream in many public sectors. In healthcare, the principles underpinning evidence-based medicine in the clinical practices have spread in the contexts of healthcare management and policy making and the amount of empirical research conducted to inform decision makers is continuously increasing. In this contest the use of economic evidence has gained importance and increasing amount of studies stemming from different disciplines and employing different research methods had investigated the phenomenon

Objectives: The objective of this study is to systematically review and compare different research methods employed to investigate the use of economic evidence in healthcare management and policy making. The secondary aim is to uncover potential strengths and limitations of different research methods and to explore approaches adopted by other social sciences disciplines (i.e economics, psychology, political science).

Methods:  We performed a systematic literature to identify empirical studies that investigated the use of economic evidence in the decision making process by clearly adopting a research method. Purely theoretical papers and commentaries were excluded. We collected data regarding the methodology used, categorized studies by research themes, and conducted a quality review of the eligible studies. Two independent reviewers screened and analyzed the articles.

Preliminary results: We found 110 eligible studies published from 2000 to 2013. Out of the 110 included studies, 78 used qualitative methods, 15 used quantitative methods, and 17 used mixed methods. The most frequent qualitative methods used included interviews, document analysis, and focus groups, and the most frequent quantitative methods were surveys.  The studies were conducted in 6 research themes: understanding decision makers’ perceptions or characteristics, evaluation of decisions that have already been made, understanding the barriers and facilitators associated with the use of evidence in the decision making process, development of decision tools  or models, resource allocation, and evaluation of strategies or interventions aimed at increasing the use of evidence in decision making, understanding the knowledge translation or evidence based decision making process as a whole.

Conclusions: This systematic review demonstrated that many of the qualitative studies primarily focused on the barriers and facilitators associated with the use of evidence and the understanding the decision making process as a whole. The use of qualitative methods suggests that researchers were interested in the process of how evidence was used in the decision making process or the process of how an intervention affected the use of evidence. The infrequent use of quantitative methods might also indicate that the constructs that are interesting may not have valid and reliable measures. Use of mixed methods study design suggests that researchers recognized that the decision making process is highly dependent on context and may use qualitative methods to provide context for quantitative analysis.