On Fundamental Premises for Addressing “Context” and “Contextual Factors” Influencing Value Decisions in Healthcare; Comment on “Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis”

Document Type: Commentary

Author

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

Abstract

In this commentary on Williams and colleagues’ paper, I will address some essential issues related to research on contextual factors that influence value decision-making in healthcare. Based on the presumption that scientific work requires coherence in its ontological, epistemological and methodological approaches, I identify some challenges in their text and reflect on how those challenges might be addressed. I recommend that more normative work be done to make this a comprehensive area of research and suggest that the fundamental premises structuring investigations in this field be explicitly clarified.

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  1. Williams I, Brown H, Healy P. Contextual factors influencing cost and quality decisions in health and care: A structured evidence review and narrative synthesis. Int J Health Policy Manag. 2018; Forthcoming. doi:10.15171/ijhpm.2018.09
  2. Guba EG, Lincoln, YS. Competing paradigms in qualitative research. In: Denzin NK, Lincoln, YS, eds. Handbook of Qualitative Research. Thousand Oaks, CA: SAGE Publications; 1994:105-117.
  3. Bærøe K, Baltussen R. Legitimate healthcare limit setting in a real-world setting: Integrating accountability for reasonableness and multi-criteria decision analysis. Public Health Ethics. 2014;7(2):98-111. doi:10.1093/phe/phu006
  4. Tromp N, Prawiranegara R, Siregar A, et al. Translating international HIV treatment guidelines into local priorities in Indonesia. Trop Med Int Health. 2018; 23(3): 279-294. doi:10.1111/tmi.13031