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Health policy research in Australia: An overview
Heather Gardner
Department of Behavioural Health Sciences, La Trobe University, Melbourne VIC
Abstract
The main difficulty in writing a review of health policy research in Australia is to know what to include. What is health policy research?' Research projects related to health rarely have policy as a specifically identified focus, but most research into health and health care, which is not exclusively clinical, has implications for policy development. Clinical research which includes an epidemiological component and explores the patterns of health and ill health in a population is, however, also relevant for health policy.
It could be argued that the kind of research which is funded has implications for subsequent policy development, for example the stress on clinical research may lead to increased costs from the impetus given to technological development and pharmaceutical usage, whereas a focus on health promotion in research may reduce costs by emphasising prevention of ill health and the social processes of health maintenance. In the end, however, it is not researchers but policy makers, political decision makers, who choose to act upon the accumulated knowledge which might inform policy. The actual policy outcomes of a piece of research are often beyond the control of the researchers themselves.
It would be a major research project in itself to fully review health policy research in Australia, so I have limited myself in this paper to providing an overview of trends with some examples of research and evaluation.
Health research is rarely defined explicitly as health policy research and few funding bodies provide a specific health policy category for grants. Rather, it is subsumed under a number of different categories, such as public health, or health education and promotion. Thus research into health policy is fragmented in terms of both the intellectual traditions within which it takes place and the sources from which it is funded.
Universities have traditionally been the recipients of grants and the sources of research, but increasingly in the area of health, other organisations, some publicly funded or supported, yet others voluntary in nature, have taken a major role in health research. In some respects health research and funding mirrors the federal system in Australia, which in turn is reflected in the organisation of the health care system in general; it is fragmented between the states and the Commonwealth and there are gaps and duplication. The positive is that this diversity brings together teams of researchers from different disciplines and from different institutions working cooperatively together to enhance knowledge. A development has been the increased number of books on health policy which have in the past three years (Crichton 1990; Gardner 1989; Gardner 1991; Palmer & Short 1989; Raffell & Raffell 1987; Sax 1990).
While it might be expected as a consequence of research traditions that the majority of research into health policy would be conducted within university departments of politics, except for some significant exceptions, this is not the case. The majority of health policy research arises from departments, faculties, institutes or centres with an emphasis on economics, sociology, environment and planning, community, social or preventative public health, or health administration and education. Exceptions are analyses of the health policies of political parties, studies of interest groups in the health area and research into health care financing which have been undertaken by political scientists. Similarly, AIDS policy research has received considerable attention from political scientists, particularly at La Trobe University and at the Australian National University. The overall trend, encouraged by federal government policy, is for the establishment of specific purpose, multidisciplinary, centres and institutes for research, frequently
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