{"title":"作为证据,什么是证据?一个二元论的例子?","authors":"Andrew Neil Fletcher","doi":"10.1057/s41285-021-00170-4","DOIUrl":null,"url":null,"abstract":"<p><p>How 'evidence' is conceptualised, generated and deployed in meso-level policy implementation on the ground is critical to health delivery. Using the case of a large-scale health service reconfiguration in northwest England, this study began as a narrative investigation into how different data types and sources are prioritised as NHS administrative structures change over time. During the research, one unpopular reconfiguration decision, the downgrading of a hospital, was challenged using judicial review. Suddenly, a key decision was being based not upon 'facts and data' type evidence but upon evidence of adherence to administrative procedure. This transferred focus away from the ever-shifting categories and hierarchies of data 'types' towards an emphasis on process. By comparing two deliberative contexts-committee and judicial review-this article proposes that evidence can be understood as simultaneously entity and process. As health service reconfigurations continue in response to austerity, integration agendas, evolving organisational landscapes, and demographic and political change, it is increasingly important to recognise the different meanings and uses of evidence.</p>","PeriodicalId":46551,"journal":{"name":"Social Theory & Health","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8594643/pdf/","citationCount":"0","resultStr":"{\"title\":\"What is evidence as evidence is used? A case of dualism?\",\"authors\":\"Andrew Neil Fletcher\",\"doi\":\"10.1057/s41285-021-00170-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>How 'evidence' is conceptualised, generated and deployed in meso-level policy implementation on the ground is critical to health delivery. Using the case of a large-scale health service reconfiguration in northwest England, this study began as a narrative investigation into how different data types and sources are prioritised as NHS administrative structures change over time. During the research, one unpopular reconfiguration decision, the downgrading of a hospital, was challenged using judicial review. Suddenly, a key decision was being based not upon 'facts and data' type evidence but upon evidence of adherence to administrative procedure. This transferred focus away from the ever-shifting categories and hierarchies of data 'types' towards an emphasis on process. By comparing two deliberative contexts-committee and judicial review-this article proposes that evidence can be understood as simultaneously entity and process. As health service reconfigurations continue in response to austerity, integration agendas, evolving organisational landscapes, and demographic and political change, it is increasingly important to recognise the different meanings and uses of evidence.</p>\",\"PeriodicalId\":46551,\"journal\":{\"name\":\"Social Theory & Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8594643/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Social Theory & Health\",\"FirstCategoryId\":\"90\",\"ListUrlMain\":\"https://doi.org/10.1057/s41285-021-00170-4\",\"RegionNum\":4,\"RegionCategory\":\"社会学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/11/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"SOCIAL SCIENCES, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Theory & Health","FirstCategoryId":"90","ListUrlMain":"https://doi.org/10.1057/s41285-021-00170-4","RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/11/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SOCIAL SCIENCES, BIOMEDICAL","Score":null,"Total":0}
What is evidence as evidence is used? A case of dualism?
How 'evidence' is conceptualised, generated and deployed in meso-level policy implementation on the ground is critical to health delivery. Using the case of a large-scale health service reconfiguration in northwest England, this study began as a narrative investigation into how different data types and sources are prioritised as NHS administrative structures change over time. During the research, one unpopular reconfiguration decision, the downgrading of a hospital, was challenged using judicial review. Suddenly, a key decision was being based not upon 'facts and data' type evidence but upon evidence of adherence to administrative procedure. This transferred focus away from the ever-shifting categories and hierarchies of data 'types' towards an emphasis on process. By comparing two deliberative contexts-committee and judicial review-this article proposes that evidence can be understood as simultaneously entity and process. As health service reconfigurations continue in response to austerity, integration agendas, evolving organisational landscapes, and demographic and political change, it is increasingly important to recognise the different meanings and uses of evidence.
期刊介绍:
Social Theory & Health provides an international scholarly forum for theoretical reflection and debate on contemporary health issues, many of which bear directly on the planning and delivery of services. The journal aims to consolidate, refine and extend theoretically informed work on the role of health in modern societies. Interest in issues of theory and health now informs many academic and practice-oriented disciplines and crosses discipline boundaries. The Editors encourage contributions from all relevant disciplines, as well as from those involved directly in front-line treatment and care. Contributions from the developing world are particularly welcome. The journal aims to include contributions from all theoretical perspectives.