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Policymakers in the health care sector have begun to ask how to make better use of health services research in developing public policy (Buxton and Hanney 1996; Eisenberg 1998; National Forum on Health 1998). Researchers have begun to provide some tentative answers to this challenging question (e.g., Coburn 1998; Davis and Howden-Chapman 1996; Eisenberg 1998; Feldman, Gold, and Chu 1997; Frenk 1992; Ginzberg 1991; Gray 1997; Klein 1997; Peterson 1995, 1997; Roos and Shapiro 1999; Soumerai, Ross-Degnan, Fortress, et al. 1997). To paraphrase the title of a recent article, many policymakers and researchers now talk of “the paradox of health services research: if it is not used, why do we produce so much of it?” (Shulock 1999).

Making better use of health services research in developing public policy requires that both health services researchers and public policymakers have realistic goals.