Clinical effectiveness research: A critical need for health sector research governance capacity

摘要

Reforms in the funding of health services, such as "activity-based" funding initiatives, seek to facilitate changes in how health care is delivered, leading to greater efficiency while maintaining effectiveness. However, often these changes in treatment strategies and service provision evolve without evidence demonstrating effectiveness in terms of patient outcomes. The pressures on health care expenditure (currently around 9% of gross domestic product) make such an approach untenable and unsustainable. The evidence necessary to support these initiatives can only be derived through carefully conducted clinical research. Most readers would immediately think of clinical trials in terms of Pharmaceuticals or clinical devices, and this type of research is critically important, although continuing to decline, in Australia.