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Databases to Efficiently Manage Medium Sized, Low Velocity, Multidimensional Data in Tissue Engineering

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Databases as policy instruments. About extending networks as evidence-based policy.

Antoinette de Bont¹, Herman Stoevelaar, Roland Bal

¹ErasmusMC, Institute of Health Policy and Management, Postbox 1738, 3000 DR Rotterdam, The Netherlands. a.debont@erasmusmc.nl

BMC Health Services Research

|December 8, 2007

Summary

Health databases, intended for policy control, were instead used by professionals for self-regulation and quality assurance, influencing physician prescribing behavior. This demonstrates a shift in control from policymakers to medical networks.

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Area of Science:

Health Policy Analysis
Information Systems in Healthcare
Pharmaceutical Regulation

Background:

Information and communication technologies are reshaping state-professional relationships in healthcare.
Databases are emerging as powerful tools influencing clinical practice and surveillance.
The study examines the evolving role of databases within health policy frameworks.

Purpose of the Study:

To investigate the development and utilization of databases as health policy instruments.
To understand the impact of databases on controlling pharmaceutical use in clinical practice.
To analyze the shift in regulatory control from policymakers to professional networks.

Main Methods:

Conducted three case studies on pharmaceutical databases (growth hormone, HIV antiretrovirals, Taxol) in the Netherlands.
Analyzed archives of the Dutch Health Insurance Board.
Performed in-depth interviews with key informants and organized focus groups involving policymakers and clinicians.

Main Results:

Databases were minimally utilized by policymakers for cost control or quality assurance.
Databases primarily facilitated self-regulation and quality assurance by professional bodies.
Physician prescription behavior became more restrictive due to database influence.

Conclusions:

Databases assumed control functions previously held by policymakers.
Databases fostered collaboration between policymakers and physicians through professional quality assurance.
Decentralized regulatory authority within physician networks offers an alternative to centralized monitoring.