This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Matchar, D. B. Search for Related Content PubMed PubMed Citation Articles by Matchar, D. B.

(Stroke. 2003;34:370.)
© 2003 American Heart Association, Inc.

Advances in Stroke 2002

Health Policy in Stroke: Translating What We Know Into What We Do

David B. Matchar, MD

From the Center for Clinical Health Policy Research and Department of Medicine, Duke University Medical Center; and Veterans Administration Medical Center, Durham, North Carolina.

Correspondence to David B. Matchar, MD, Center for Clinical Health Policy Research, Duke University Medical Center, 2200 W. Main St, Suite 220, Durham, NC 27705. E-mail match001@mc.duke.edu

Key Words: decision sciences • health economics • health policy • health services research • outcomes research • practice improvement • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Health policy is often perceived (sometimes correctly) as an arcane pursuit of politicians, lobbyists, and assorted governmental bureaucrats. More correctly, health policy is an activity that is fundamental to the clinical enterprise. It is the decisions of health policy makers that determine what medical services will be reimbursed, mandated, or otherwise promoted and what services will be rejected for payment, proscribed, or otherwise inhibited.

Health policy is practiced at the level of clinical practice organizations and professional societies (in the form of guidelines or practice improvement efforts) or by legislative or regulatory entities (in the form of new training programs, insurance structures, legal requirements, and so on). Whether at the level of clinical policy or public policy, it is generally agreed that health policy should be driven by the best scientific evidence. The challenge for those decision makers who create health policy is to draw on a broad range of evidence and not merely the literature on what works (ie, what has a biological effect). This broader evidence base addresses (1) whether that effect relates to a health outcome that people care about; (2) whether the outcome is worth the cost; and (3) whether it is feasible to provide the interventions that improve outcomes in real-world settings.

One may argue that health policy research in stroke is some years behind efforts in other medical conditions (notably cardiac disease, cancer, and AIDS). However, the field is making notable progress. Below, several studies published in 2002 are cited to illustrate recent work . . . [Full Text of this Article]