Black N
Soc Sci Med. 1982;16(20):1801-6. doi: 10.1016/0277-9536(82)90274-x.
Scientific approaches, such as operational research and health economics, have failed to resolve many of the problems confronting managers of health services. This is partly because of assumptions about the value-free nature of information and partly through paying little regard to power conflicts in care systems. The case-study method offers a means of understanding some aspects of these conflicts and could therefore improve the effectiveness of scientific methods in influencing decisions. An example of a case-study involving perinatal care in an English health district is described in an attempt to demonstrate the practical benefits that could accrue to managers hoping to see their macro-study findings effecting change.
诸如运筹学和卫生经济学等科学方法，未能解决卫生服务管理者面临的许多问题。部分原因在于对信息价值中立性的假设，部分原因在于对医疗系统中权力冲突的忽视。案例研究法提供了一种理解这些冲突某些方面的方法，因此可以提高科学方法在影响决策方面的有效性。本文描述了一个涉及英国某卫生区围产期护理的案例研究示例，旨在展示可能惠及那些希望看到其宏观研究结果带来变革的管理者的实际益处。
