Introduction

Policymakers, payers, and health care providers are responsible for deciding which health services should be provided to whom to help reduce the burden of disease, disability and death. To achieve this goal, evidence-based information is required to make the precise decisions. Since health service resources need to be spent efficiently, steps in health information inquiries have been proposed. These steps are shown as the Technology Assessment Iterative Loop (TAIL) as discussed in the Introduction. In this chapter, we will focus on the community effectiveness, which is the third step in the TAIL.

The rationale of community effectiveness is to determine how well an intervention with the potential for reducing burden will work when applied in the community. Community effectiveness may be considered as the 'real world' efficacy of an intervention since it is affected by certain external elements. Community effectiveness is determined by five factors: efficacy, screening and diagnostic accuracy, health provider compliance, patient compliance, and coverage.