What is Health Services Research?
The definition of Health Services Research is constantly evolving and has been defined differently by a number of thinkers and organizations. Among the most comprehensive definitions are recent ones by the Agency for Healthcare Research and Quality and the Academy for Health Services Research and Health Policy. Health services research . . . examines how people get access to health care, how much care costs, and what happens to patients as a result of this care. The main goals of health services research are to identify the most effective ways to organize, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety. (Agency for Healthcare Research and Quality, 2002 ) Health services research . . . is the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communities, and populations. (Academy for Health Services Research and Health Policy, 2000) Health services research . . . is a multidisciplinary field of inquiry, both basic and applied, that examines the use, costs, quality, accessibility, delivery, organization, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations (IOM, 1995) Health services research . . . is concerned with problems in the organization, staffing, financing, utilization, and evaluation of health services..[It] subsumes both medical care and patient care research. It could well be termed "socio-medical" research. (Flook and Sanazaro, 1973:1) Health services research . . . is a recognized, multidisciplinary field...[with a focus on certain generic issues, such as] the organization and financing of medical care, utilization patterns, patient and provider relations, social and behavioral epidemiology, health information systems, and monitoring and evaluation of health services. (Marshall, 1985:381,382) Health services research . . . is the integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. (Last, 1988:58) Health services research . . . is inquiry to produce knowledge about the structure, processes, or effects of personal
government. statistics. . .g.. review or analysis of health systems. . and management of health care services on the delivery. The field draws on many disciplines to address this breadth of research. a comprehensive set of variables involving health care techniques. in part because of its markedly multidisciplinary nature. health economics. and prevention in the provision of health care services. or both. (Valentine. medicine. it uses a particularly disparate set of theories. national. empirical data collection.. and the factors that influence health states. processes.. or effects of personal health services. manpower. and combination and integration of these variables in many ways.g. 1979:14) Health services research .health services..g. 1991:10) Health services research . operations research. development of research instruments and methodologies. frequently emphasizing the nonbiological aspects of health and medical care (IOM. health interventions. nursing. is a field of inquiry that examines the roles of organization. and outcomes of such services. most current. epidemiology. (IOM. future trends). and medical sociology. technology. quality. 1991:8)
. financing. and quality of care. 1979
• • • •
A focus on the health states of individuals or populations.g.. policy and operational decision making). international. cost. psychology. it has diverse purposes (e. 1991:6)
What is Health Services Research? Health Services Research Components from the IOM Report. county) and on broad populations as well as specific population subgroups. finance. At least one of the features is related to a conceptual framework other than that of contemporary applied biomedical science (IOM. including biostatistics. is a field of inquiry that examines the impact of the organization. . and their impact on utilization. it is conducted in many different settings (e. academia. historical. and devices and instruments derived from various disciplines. access to. and it uses a wide range of time frames for data collection and analysis (e. it focuses on several different geographic levels (e. (Steinwachs. 1991) Health Services Research: Selected Characteristics The field of health services research presents a number of sizable challenges. clinical health care settings). cost. concepts. A study is classified as health services research if it satisfies two criteria: it deals with some features of the structure. state.. practices. programs and policies. For instance:
• • • •
it lacks a widely adopted standard definition or conceptual structure.
p.23-72.L. MI: Health Administration Press. Institute of Medicine. Improving Information Services for Health Services Researchers. Sanzaro. 1991. D.E. Health Services Research: An Anthology. 1979. A Report to the National Library of Medicine. 1992. Steinwachs. J. Marshall.J. 1995. Association for Health Services Research. 1985. 23:381-382. In: P. Institute of Medicine. Last.M. 2d ed. Washington. DC: Association of Academic Health Centers. In: E. Washington. J. June 12.E. eds. Health Services Research and R&D in Perspective. Chapter 1. Valentine. Medical Care. Forman. 1988. Promoting Health Services Research in Academic Health Centers. Flook and P. Health Services Research: Origins and Milestones. 1991. Washington. 1993. Health Services Research: Its Scope and Significance.. Institute of Medicine. Ann Arbor. ed.: National Academy of Sciences. P.E. 1991. ed. 534). W. E. Committee on Health Services Research: Training and Work Force Issues.
. Personal Communication. Health Services Research.M. (Scientific Publication.Sources: Flook. DC: National Academy Press. New York:Oxford University Press. A Dictionary of Epidemiology.C. DC: Pan American Health Organization. Washington.J.D. K. and Sanazaro. Health Services Research: Workforce and Educational Issues. White. Introduction.
This extends from establishing what care • Current should be provided and how services should be organised. provision of an 'on-call' facility to advise the Department of Health about international comparisons. Our staff reflect both the multi-disciplinary (epidemiology. through research on the organisation of health care providers and purchasers. We achieve these aims partly through close links with clinicians (in particular in surgery. Most of our research is in high income • Programmes countries and. through studies assessing the quality of existing services. in particular. workforce and governance. support a similar unit at the Royal College of Obstetricians & Gynaecology. pharmacy) nature of our work. Assessing the quality of existing services involves the development of outcome measures. psychology. medicine. being a key part of the European Observatory on Health Care Systems. health policy) and multiprofessional (nursing. to how improvements can be brought about. and research on health systems carried out
. the UK. history. Fax: +44 (0)20 7927 2701
Students Tel: Research
Established in 1988.Department of Health Services Research and Policy
HSRP Home Head
• • •
of Deparment: Nicholas Mays Deparment Research Degree Co-ordinator: John Cairns Staff Deparment Administrator: Debby Stanley +44 (0)20 7927 2366. to national and international policies on funding. our aim is to carry out research that helps to improve the quality. Establishing what care should be provided and how services should be organised involves primary evaluative research (on particular health care interventions and policies). statistics. we run the Clinical Effectiveness Unit at the Royal College of Surgeons of England. organisation and management of health • Publications services and systems. reviews of existing research evidence and modelling possible options. economics. critical care and obstetrics) and by hosting the National Centre of Health Outcomes Development for the NHS Information Centre for Health & Social Care. In addition to specific projects. sociology. We also provide economics input to the NICE National Coordinating Centre for Cancer. Our work on improving health services and systems extends from the creation of clinical guidelines for managing patients. indicators and data collection methods. Achievement of these aims is enhanced by our shared responsibility for the NICE National Coordinating Centre for Acute Care.
The Unit includes the Department of Health's National Centre for Health Outcomes Development. and hence. See: Healthcare Policy journal. This journal published its first issue in September of 2005. the Royal College of Surgeons' Clinical Effectiveness Unit and hosts part of the European Observatory on Health Care Systems. but also to those who make decisions about health policy. the Centre for Policy in Nursing Research. are readily available to all those with an interest in health policy and services? First. Canada’s unique policies for the delivery of health services merit research that has a focus on this particular health system. Excerpt:
Healthcare Policy is designed to be a key knowledge translation vehicle
. An example of a Canadian health services research journal is Healthcare Policy. the NHS National Co-ordinating Centre for Service Delivery and Organisation Research & Development. For examples of articles about HSR. see the collection published by CMAJ. It’s a field that’s of interest not only to those who do the research.com/2008/02/11/assessing-health-services-research-journals/
Public policies about health services vary greatly both between and within countries.wordpress. the European Centre on Health of Societies in Transition.as part of the European Centre On the Health Of Societies in Transition.
http://tillje. and to those who are affected by such decisions. a Canadian perspective. How to assess existing HSR journals? Which HSR journals publish articles that are openly accessible. CIHR Institute of Health Services and Policy Research (IHSPR). “Health services research” (HSR) is a field of research that deals with various aspects of health systems.