Epidemiology of indications

The recent editorial by Frankel on the epidemiology of indications' is an excellent review of the problem of the interface between research and practice, and the impact of governmental policy decisions on the provision of health care.Frankel is correct in defining the confusion that exists between health care and health needs.He is also correct in outlining the deficiencies that exist in our ability to influence decisions on priorities, purchasing, etc.His sensitive analysis of the role of the population in defining what needs to be done, or what can be done, is good.However, his analysis of the issues has omitted examination of the past and is deficient in the blame that he attaches to various groups.A striking omission of the current NHS reforms has been lack of consultation with expert groups.Many of the changes that were introduced through green and white papers and other documents were promulgated following inade- quate consultation between those with knowledge of health services and health services research findings and those concerned with health policy formulation at department level.To some extent our own professional group shares this blame- the Department of Health work on epidemiologically based needs assessment was commissioned by the management executive and undertaken by a variety of groups.It is amazing that those involved in this work neglected Department of Health commissioned research from 10 or more years previously.Many researchers are critical of those concerned with the commissioning of research and the determination of research priorities.The

Environmental health · Family medicine · Pathology · Delphi Technique in Research · Epidemiology · Medicine

• Epidemiology of indications

  Gordon Pledger•Journal of Epidemiology and…•1992

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• The epidemiology of indications

  Stephen Frankel•Journal of Epidemiology and…•1991

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