Eur J Public Health. 2011 Jan 1;21(Supplement 1):258.
Despite the central influence of public policies on health and welfare, relatively little is known about actual health care policy-making processes. This presentation will offer preliminary results from a federally funded project aimed at gaining insights into the interrelations among interest-group strategies, media discourses and political debates in health care. The policy debate on health care privatization in Quebec is used as a case study. APPROACH: Two sources of data were used: media sources and political debates. Media sources were the six main provincial newspapers in Quebec, two national newspapers and The Canadian Press, as well as transcripts from specific news-related programs of three national television stations and two national radio stations. Political debates were obtained through transcripts of all question periods in the Parliament and debates in the standing committee on health. Sources were systematically searched to identify all relevant data. Multiple search syntaxes were developed and tested to maximize sensitivity and specificity. All data was entered and coded into qualitative analysis software. RESULTS: Data was analyzed longitudinally from June 2005 to January 1, 2010. Four levels of results will be presented: 1) Descriptive analysis of the interest groups involved, their policy preferences and the rhetoric they employed to support their views. 2) Descriptive analysis of the main policy proposals that structured the debate as well as of the coalition of groups behind those proposals. 3) Graphic longitudinal analysis of the intensity of the debate and of the relative importance and evolution of various policy proposals. 4) Preliminary results on the nature, direction and level of inter-influence between the policy and media agendas. CONCLUSION: This presentation provides empirical evidence on current policy-making processes in health care. It shows, unsurprisingly, that policy-making is a circumvoluted process of inter-influence among interest groups, politicians and the media. It also highlights the fact that scientific evidence actually plays a minor (if any) role in policy processes.
尽管公共政策对健康和福利具有核心影响力，但对于实际的医疗保健政策制定过程却知之甚少。本报告将展示一个由联邦政府资助项目的初步结果，该项目旨在深入了解医疗保健领域利益集团策略、媒体话语和政治辩论之间的相互关系。以魁北克省医疗保健私有化的政策辩论为例进行研究。
使用了两种数据来源：媒体资料和政治辩论记录。媒体资料包括魁北克省六家主要省级报纸、两家全国性报纸和加拿大通讯社，以及三个全国性电视台和两个全国性广播电台特定新闻相关节目的文字记录。政治辩论记录通过议会所有问答环节的文字记录以及卫生常务委员会的辩论获得。对资料来源进行系统搜索以识别所有相关数据。开发并测试了多种搜索语法，以最大限度地提高敏感性和特异性。所有数据均输入并编码到定性分析软件中。
对2005年6月至2010年1月1日的数据进行了纵向分析。将展示四个层面的结果：1）对所涉及利益集团、其政策偏好以及用以支持其观点的言辞的描述性分析。2）对构成辩论的主要政策提案以及这些提案背后的集团联盟的描述性分析。3）对辩论强度以及各种政策提案的相对重要性和演变的图形化纵向分析。4）关于政策议程和媒体议程之间相互影响的性质、方向和程度的初步结果。
本报告提供了有关当前医疗保健政策制定过程的实证证据。不出所料，它表明政策制定是一个利益集团、政治家和媒体之间相互影响的复杂过程。它还突出了科学证据在政策过程中实际上作用甚微（如果有作用的话）这一事实。
