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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Make it Purpose Driven, Ethical, Equitable, and Sustainable.
Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke
2010 Scientific SessionsMark Gibson, Director
Center for Evidence-based PolicyOregon Health and Science University
May 20, 2010Washington, D.C.
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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
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Presenter Disclosure Information
• Mark Gibson• Make it Purpose Driven, Ethical, Equitable,
and Sustainable.
FINANCIAL DISCLOSURE: Receives funding from state Medicaid programs, NIMH, and the Milbank Memorial Fund. No business conflicts.
UNLABELED/UNAPPROVED USES DISCLOSURE: None
Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Defining the Purpose of Health Care
• Economic Commodity– Business development– Employment– Benefits of employment
• Health as Sole Purpose of Healthcare
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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Values Problem
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• Pursuit of Happiness (Health)– Personal assets– Community assets
• Pursuit of Profit– Ethics of health care business– Legal compliance insufficient
Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Oregon Health Plan
• Goal is improving population health
• Limits are real
• Priorities must be established
• Some services won’t be provided
• Population treated equitably
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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Priority Setting
• Based on Benefit, Harm, and Cost (Eddy)– Better for population than nothing– Outweighs harms in improving health– Comparatively better– Empirical evidence trumps subjective– Burden of proof lies with advocates of service
• Outcomes Reflect Patient Preferences
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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Issue of Connectivity
• Used There, Lost Here
(Conservation International)
• Era of Behavior (Seidman)– Ethical connectivity– Situational ethics– Sustainable ethics
• Generational Challenge
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Center for Evidence-based PolicyGlobalizing Evidence, Localizing Decisions
Contact Information
Mark Gibson, Director
Center for Evidence-based PolicyOregon Health and Science University
3455 SW US Veterans Hospital Road
Portland, OR 97239-2941
503-494-2679
www.ohsu.edu/policycenter
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