Identifying and Assessing Good and Best Practices in Health

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In this third module, students are introduced to the evaluation of prevention and care in the European region, and to the identification and selection of best practices. They learn about models for evaluation and selection of best practices based upon criteria of equity, humanity, client satisfaction, efficiency, effectiveness and cost-effectiveness; they familiarise themselves with the methodology to assess the effectiveness and cost-effectiveness of prevention and care; and learn how these models and methods can be applied for cross-national comparison. In addition, they learn how to apply systematic reviews and benchmarking with a view to standardisation and best practices. The methodologies of health impact assessment (HIA) and health technology assessment (HTA) are introduced and applied. The students also study the international comparability of cost of illness. 2. Module Content 2.a. Contents: At the start of the module, students learn about different approaches to the evaluation of prevention and care. They are introduced to the different goals of process versus output and outcome evaluation, and learn about the methods for the assessment of the effectiveness and cost-effectiveness of interventions for prevention and care. Specifically, they are introduced to the hierarchy of evidence for defining best practices, including systematic reviews and meta-analysis, randomised controlled trials, cohort studies, case-control studies, cross-sectional surveys, case reports, and expert opinions. They are also introduced to criteria and protocols that have been specifically designed to address scientific evidence for public health interventions, including the Cochrane Library and review protocols, and are invited to critically reflect on the applicability of these approaches to public health and health promotion. In close connection to the Essentials and Project strands, the students gain a thorough understanding of systematic reviews and economic evaluation (notably cost-effectiveness, cost-benefit and cost-utility analyses). The different steps of a systematic review process and the methodologies of health impact assessment (HIA), health technology assessment including economic evaluation (HTA) are introduced and applied. Next, the students learn how to apply these models and methods for cross-national comparison and they explore methods for benchmarking based on standardisations and best practices. Further emphasis is given to the question how cross-national and cross-regional research methodology is feasible. Students learn to identify pitfalls in cross- national and regional research and how to improve such research methodologically. This means using techniques to assure comparability and standardisation of the methods employed in each country. As this is the first module to deal explicitly with the concept of ‘best practice’, students critically reflect on this concept from the perspective of the philosophy of health sciences. A first strand of discussion leaves from a critical appraisal of evidence-based medicine (and Randomised Controlled Trials) and leads to lessons to learn for European Public Health. To consolidate the understanding of evaluation and review, respectively, and to learn how to apply the theoretical knowledge, practice sessions are foreseen to learn to apply the different steps of a systematic review process and of health impact assessment and health technology assessment. In addition, a field trip to Luxembourg will be arranged to sensitise the students to topics for Module 4, including: policymaking and the world of politics, ‘lobbying’ to the European Institutions and working with civil society. The trip involves visits to a Directorate General of the European Commission, the Executive Agency for Health and Consumers, and possibly the European Parliament.