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


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


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.


Main Subjects

  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
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  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