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Evaluation of healthcare systems, with its significant use of qualitative data, has to date remained the poor relation to conventional research methods. However, study designs such as randomised control trials are of limited use when occupational health services seek to describe their own practice or are asked to justify programmes to employers, who expect such activities to impact on the functioning of their organisations. The evaluation approach, developed partly in the social sciences, helps provide models for such research questions. Calls for a greater emphasis on such studies have been heard in the BMJ and Occup Environ Med. Menckel and Westerholm's book coherently draws together the conventional study methods and these newer approaches. In doing so the potential researcher is encouraged to seek clarity of thought in the question to be addressed before the study design is selected, to consider the role and expectations of stakeholders, and to consider the wide range of potential outcomes from any occupational health programme.
The evaluation approach requires a knowledge of systems theory and this book provides a useful introduction that may help occupational health specialists see the workings of their own departments in a new light. The book has a consistent emphasis on occupational health experience and rarely strays into unnecessary theory. The principal weakness is a lack of worked examples on common themes in occupational health practice—for example, management of sickness absence. However, as the authors observe, comparatively few evaluation studies have been published in the occupational health literature and this book will no doubt help correct this situation.
This thought provoking book encourages reflection on the daily practice of occupational health and offers a wide range of approaches that may be adopted to evaluate common issues. Such approaches may lead not only to formal research but also to well informed management decisions on the development and impact of occupational health services. In conclusion this book is worthy of inclusion alongside standard texts of statistical and research methods, but is likely to be of greater use in the day to day management of occupational health services.
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