Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal

Document Type : Perspective


Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada


Health services and policy research (HSPR) represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publiclyfunded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending.


Commentaries Published on this Paper

  • Health Services Research Spending and Healthcare System Impact; Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

          Abstract | PDF

  • Making Research Matter; Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

          Abstract | PDF

  • Public Spending on Health Services and Policy Research in Canada: A Reflection on Thakkar and Sullivan; Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

          Abstract | PDF


Authors’ Response to the Commentaries

  • Eating or Feeding Our Young: A Response to Recent Commentaries

          Abstract | PDF


Main Subjects

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  • Receive Date: 08 February 2017
  • Revise Date: 27 March 2017
  • Accept Date: 28 March 2017
  • First Publish Date: 01 November 2017