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The purpose of this paper is to analyze how staff and managers in health and social care organizations use scientific evidence when making decisions about the organization of care practices.

Document analysis and repeated interviews (2008-2010) with staff (n=39) and managers (n=26) in health and social care organizations. The respondents were involved in a randomized controlled study about testing a continuum of care model for older people.

Scientific evidence had no practical function in the social care organization, while it was a prioritized source of information in the health care organization. This meant that the decision making regarding care practices was different in these organizations. Social care tended to rely on ad hoc practice-based information and political decisions when organizing care, while health care to some extent also relied in an unreflected manner on the scientific knowledge.

The study illustrates several difficulties that might occur when managers and staff try to consider scientific evidence when making complicated decisions about care practices.