Evidence and Health Policy: Using and Regulating Systematic Reviews.

Systematic reviews have, increasingly, informed policy for almost 3 decades. In many countries, systematic reviews have informed policy for public and population health, paying for health care, increasing the quality and efficiency of interventions, and improving the effectiveness of health sector professionals and the organizations in which they work. Systematic reviews also inform other policy areas: criminal justice, education, social welfare, and the regulation of toxins in the environment.

Policy commercializing nonprofits in health: the history of a paradox from the 19th century to the ACA.

Unlabelled: POLICY POINTS: Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector. This policy paradox persists during the implementation of the Affordable Care Act of 2010.

Context: For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization.

Health inequality and governance in Scotland since 2007.

Background: Since Scottish devolution in 1999, successive governments have accorded priority to reducing health inequality and increasing economic growth. The Scottish Nationalist Party Government elected in 2007 and re-elected in 2011 has accorded considerable attention and allocated substantial resources to addressing these priorities. This article describes why, how and with what results to date the participants in the governance of Scotland, broadly defined to include persons outside as well as within central government, have addressed the determinants of health in order to reduce inequality and, as a result, improve the health status of the population.

The governance of disease control in Europe.

The eight articles on the governance of communicable disease control in Europe in this issue contribute information and insight to the literature on health politics, policy, and law. Each is a carefully researched and well-argued analysis of a subject on which its authors are experts. The set will be useful to scholars of comparative health policy as well as to specialists in European affairs.

Systematic reviews and health policy: the influence of a project on perinatal care since 1988.

Context: Interrelated publications between 1988 and 1992 have influenced health policy and clinical practice: The Oxford Database of Perinatal Trials (ODPT), Effective Care in Pregnancy and Childbirth (ECPC), A Guide to Effective Care in Pregnancy and Childbirth (GECPC), and Effective Care of the Newborn Infant (ECNI). These publications applied and advanced methods that had a substantial history in the medical, biological, physical, and social sciences. Their unique contribution was to demonstrate the feasibility of organizing and sustaining programs to conduct systematic reviews across an entire field of health care.

The governance of standard-setting to improve health.

This article describes recent events in the governance of standard-setting for 2 areas of US health policy - states' decisions about which prescription drugs to cover under Medicaid and other public programs and making health an aspect of foreign policy - and whether these events offer lessons for policy making. In prescription drug coverage, methodologic advances in research that evaluates health services and the politics of restraining the rate of growth in health expenditures enabled policy makers in most states to establish new public processes for assessing and applying evidence about the effectiveness of competing drugs. Their counterparts in foreign policy, in contrast, made few changes in existing processes for choosing which interventions to support.

The case for a national patient library.

A national patient library that stored and communicated findings from research on the comparative effectiveness of health services could be a valuable resource for patients and clinicians. It could assist in improving the quality of health care and help reduce inappropriate costs. Public confidence in a national patient library would require that its activities be insulated from government as well as from professional, provider, payer, and commercial groups and advocacy organizations.

Realizing and allocating savings from improving health care quality and efficiency.

International efforts to increase the quality and efficiency of health care services may be creating financial savings that can be used to improve population health. This article examines evidence that such savings (ie, a quality/efficiency or value dividend) are accruing and how they have been allocated and assesses the prospects for reallocating future savings to improve population health. Savings have resulted mainly from reducing the number of inappropriate or harmful interventions, managing care of people with chronic disease more effectively, and implementing health information technology.