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3 - The Benchmark Decision Model, the Value of Evidence, and Alternative Decision Processes

Published online by Cambridge University Press:  14 July 2022

Mark Pauly
Affiliation:
University of Pennsylvania
Flaura Winston
Affiliation:
Children's Hospital of Philadelphia
Mary Naylor
Affiliation:
University of Pennsylvania School of Nursing
Kevin Volpp
Affiliation:
University of Pennsylvania Health System
Lawton Robert Burns
Affiliation:
University of Pennsylvania
Ralph Muller
Affiliation:
University of Pennsylvania Health System
David Asch
Affiliation:
University of Pennsylvania School of Medicine
Rachel Werner
Affiliation:
University of Pennsylvania School of Medicine
Bimal Desai
Affiliation:
University of Pennsylvania School of Medicine
Krisda Chaiyachati
Affiliation:
University of Pennsylvania School of Medicine
Benjamin Chartock
Affiliation:
Wharton School, University of Pennsylvania
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Summary

It seems so obvious that good decisions on innovations in medical and hospital management – or on anything – should be based on good evidence. Decision-makers are advised by business school professors (and their mothers) that decisions should be based on the best available evidence – and who could argue against that? However, despite the general reverence for evidence in medical practice and drug approval, there is a consensus (discussed later in this chapter) that decision-making on medical delivery or insurance innovations – which also can have effects on health, life, death, and spending – is often not evidence-based, sometimes contradictory to evidence, and surely not as evidence-based as it could be. In this introductory chapter we explore two related questions: (1) what is the value of evidence for these decisions, and (2) where in health care management is evidence not being generated or used as it should be? This chapter will in a sense discuss “evidence on evidence,” and ask when and what kind of evidence is needed to improve not only decision-making, but also final outcomes in terms of spending and quality.

Type
Chapter
Information
Seemed Like a Good Idea
Alchemy versus Evidence-Based Approaches to Healthcare Management Innovation
, pp. 29 - 63
Publisher: Cambridge University Press
Print publication year: 2022

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