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Policy Lessons (policy + lesson)

Distribution by Scientific Domains

Medical Sciences	60%

Selected Abstracts

The cost effectiveness of specialised facilities for service users with persistent challenging behaviours

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001
Angela Hallam MSc
Abstract Little systematic research relates specifically to the last people to leave a psychiatric hospital at the end of a closure programme. The long-running evaluation of the reprovision of services from Friern Hospital in North London allowed a special study to be made of such a group (67 people in all), whose range of problem behaviours made placement in community settings most difficult. The patients were relatively young, with a shorter length of stay than the remainder of the former long-stay hospital population. They were assessed three times: before leaving Friern, and one and 5 years after relocation. The social and clinical characteristics of each person were measured, and the full costs of their care calculated. The ,difficult-to-place' patients moved to four highly staffed rehabilitation facilities, where the total cost of their care was, on average, £1230 per week. There was no overall change in their psychiatric state over the 5 years after they left Friern Hospital although, in the longer-term, they gained skills in several areas of daily functioning. Most importantly, there was a fall of almost 50% in the number of challenging behaviours exhibited by the study group. At the five-year follow-up point, the cost of care had fallen, on average, by £170 per week, and 24 people had been able to move to more independent accommodation arrangements. Study participants had gained a new network of community service contacts, and used services provided by a greater variety of agencies. The indicators suggest that high expenditure on alternative care was justified retrospectively by overall long-term outcomes. An important policy lesson from the Friern Hospital reprovision study is that adequate funds should be reserved until the end of the closure programme to allow the investment of resources in provision for patients with the most severe problem behaviours. [source]

What are the policy lessons of National Alcohol Prohibition in the United States, 1920,1933?

ADDICTION, Issue 7 2010
Wayne Hall
ABSTRACT National alcohol prohibition in the United States between 1920 and 1933 is believed widely to have been a misguided and failed social experiment that made alcohol problems worse by encouraging drinkers to switch to spirits and created a large black market for alcohol supplied by organized crime. The standard view of alcohol prohibition provides policy lessons that are invoked routinely in policy debates about alcohol and other drugs. The alcohol industry invokes it routinely when resisting proposals to reduce the availability of alcohol, increase its price or regulate alcohol advertising and promotion. Advocates of cannabis law reform invoke it frequently in support of their cause. This paper aims: (i) to provide an account of alcohol prohibition that is more accurate than the standard account because it is informed by historical and econometric analyses; (ii) to describe the policy debates in the 1920s and 1930s about the effectiveness of national prohibition; and (iii) to reflect on any relevance that the US experience with alcohol prohibition has for contemporary policies towards alcohol. It is incorrect to claim that the US experience of National Prohibition indicates that prohibition as a means of regulating alcohol is always doomed to failure. Subsequent experience shows that partial prohibitions can produce substantial public health benefits at an acceptable social cost, in the absence of substantial enforcement. [source]

From policy lessons to policy actions: motivation to take evaluation seriously

PUBLIC ADMINISTRATION & DEVELOPMENT, Issue 4 2004
Gustavo Gordillo
The purpose of this article is to analyse the institutional aspects of creating effective systems for monitoring and evaluations (M&E) in government-led rural development efforts in developing countries. We argue that the ultimate challenge of creating effective M&E systems for public policy is not only related to the supply of information and the delivery of new knowledge to policy makers, but more importantly to their demand for lessons learnt about the effects of earlier policies. The challenge, then, is for governments to construct institutional arrangements that support the transformation of policy lessons into policy actions. This article shows that the likelihood of this transformation is closely related to the capacity of institutions to deliver mechanisms for downward accountability and processes for organisational learning. We add to earlier work in this area by considering the conditions under which such a transformation process is more or less likely, given the severe power and information asymmetries that characterise the institutional context of many developing countries' national governments. We use the tools of institutional analysis to examine the incentive structures of the actors involved in two concrete field settings, and assess to what extent these actors are likely to take evaluations seriously. Copyright © 2004 John Wiley & Sons, Ltd. [source]