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Table 8 Representative quotes on the barriers to the use of HSPR in health policymaking/decision making in Israela

From: Views of health system policymakers on the role of research in health policymaking in Israel

Theme Representative quotes
1. Barriers related to the actual research and dissemination of the research  
• The research is not timely The time from when the study was conducted until it was published. This is a general problem with research – it takes too long until they are published and it is unclear that the data is still relevant to current reality. One of the problems is that it is very rare that you have the information you want. The problem is you want to get information, information that you don’t have, and do not have time to wait for it. Most of the studies that I see come after the fact, and this is 20/20 hindsight.
• The research is not always relevant i.e. the research question does not match the need [Researchers] don’t always ask us what we need to know, what are the issues that interest us, before planning the research. Then they come and say, “Use this,” but we do not need it.
• Research from other countries is not always applicable Discrepancies between international research and international data and the situation in Israel Doubts about the relevance of studies and data from overseas to the unique situation in this country, requires self-examination, [that] cannot always be done.
• Concerns regarding the type of research and the quality of research Research where it is not clear what was their methodology… I want to see the methodology of the study to see how much I can trust it, critically, and if I do not have access to the methodology, it makes it difficult for me.
• Dissemination of the research results Studies get published but they remain at the level of articles and conferences, but they don’t break down into the particulars to examine applicability.
2. The ability to make the change in the organization We have a highly structured health system with a particular structure where it is not always easy to implement, to fit some things to the evidence, in a framework where it’s very difficult to make changes in the structure of our system.
3. Interests from different stakeholders (including political agenda) There are all sorts of considerations for the HMOs in implementing… especially of the doctors and, definitely, of the government. Barriers of personal views, of politics, the media, the pressures from voters, the wealthy. Some will adopt this wholeheartedly. If it fits with your doctrine, then it’s very good to come out and say “I just happened to find …”.
4. Policymakers’ preconceived notions regarding decision making and attitudes towards research People have preconceptions about what should be done, no matter what the study shows. The main problem is that policy makers in Israel do not want to make decisions based on data, and certainly in cases where the data do not support their gut feelings, their ideology, their tradition … don’t want to hear, don’t want to implement, don’t want to internalize it.
5. Policymakers’ understanding of the research Many of the policy makers do not know how to read research … social research, which is what create policies, add other variables to the picture, variables that doctors don’t have a clue. They sometimes do not even realize their importance.
  1. aThe themes in the table are presented from the most to the least common themes mentioned in the interviews