Economic Rationality in Decision-Making Regarding Newborn Screening: A Case Study in Quebec.

Area of Science:

• Health economics
• Perinatal medicine
• Public health policy

Background:

• Health systems increasingly rely on scientific evidence for service decisions.
• Generating evidence for rare conditions, like in newborn care, presents significant challenges.
• Methodological advancements in economic evaluation offer potential solutions for evidence-based decision-making.

Purpose of the Study:

• To explore Quebec decision-makers' perceptions of recent economic evaluation advances for perinatal studies.
• To understand how these advances influence decisions on neonatal interventions within the public health care system.

Main Methods:

• A qualitative study design was employed.
• Semi-structured interviews were conducted with 10 policymakers.
• A neo-institutional framework (structure, power, interpretive schemes) guided data collection and analysis.

Main Results:

• Structural factors, interpretive schemes, and power dynamics facilitate evidence generation for newborn services.
• Decision-making considers the unique aspects of neonatology, including the social value of children.
• The difficulty in producing evidence does not impede the provision of essential newborn care.

Conclusions:

• Existing frameworks effectively address challenges in generating evidence for neonatal care.
• Societal values, beyond quantifiable data, are crucial in decisions regarding neonatal interventions.
• Economic evaluation advances can support, but do not solely dictate, healthcare decisions in neonatology.