Policy ForumHEALTH CARE POLICY

Randomize evaluations to improve health care delivery

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Science  13 Feb 2015:
Vol. 347, Issue 6223, pp. 720-722
DOI: 10.1126/science.aaa2362

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Summary

The medical profession has long recognized the importance of randomized evaluations; such designs are commonly used to evaluate the safety and efficacy of medical innovations such as drugs and devices. Unfortunately, innovations in how health care is delivered (e.g., health insurance structures, interventions to encourage the use of appropriate care, and care coordination approaches) are rarely evaluated using randomization. We consider barriers to conducting randomized trials in this setting and suggest ways for overcoming them. Randomized evaluations of fundamental issues in health care policy and delivery should be—and can be—closer to the norm than the exception.