Health services research examines the quality of health care in the real world, 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 the variation in medical practice and medical errors; and improve patient safety. Health services research is broad in its approach, and considers interventions across the spectrum from health promotion and illness prevention through treatment to rehabilitation, recovery and care of the terminally ill.
Why should we do health services research?
Health Services research helps to increase our knowledge and understanding of the structures, processes, and effects of health services for individuals and populations. Unlike many other forms of health research, health services research often has the potential to improve health care as well as generate savings in the health system by providing evidence about the best way to deliver health care that achieves optimal outcomes at the most reasonable cost.
What are the common types of research questions answered by health services research?
Health Services research can provide answers across a range of issues:
- Clinician and, patient behaviour Health services research can identify strategies to enable useful health behaviours regarding treatment, prevention, and cost-effective use of services.
- Access to health care Health services research can document the effects of patient socioeconomic characteristics, and other variables on access as well as the impact of access on health status.
- Utilisation Health services researchers can investigate patterns of use of services, such as hospital care, doctors, and prescription drugs.
- Quality of care Health services research can measure indicators of quality of care and evaluate the performance of providers.
- Clinical evaluation Health services research can clarify the benefits and risks of preventive, diagnostic, and treatment procedures so clinicians and providers can make realistic decisions.
- Health professions work force Health services research can study the current and future needs for health personnel and services and the way that they are trained.
Investigations conducted by health services researchers might include:
- Patients' satisfaction with pain management and its impact on their quality of life.
- Effectiveness of chemotherapy for advanced lung cancer in the elderly.
- The effects of message framing on breast cancer related beliefs and behaviours.
- Patient satisfaction with in-hospital cancer care
- The cost of in-home care versus hospital care.
- Evaluating a shared care protocol between primary and secondary care for the ongoing management of terminal cancer patients.
- The prevalence and severity of side effects and complications associated with pain management.
- The variation in surgical treatment for colorectal cancer
Limitations of Health Services Research
Well executed health services research often involves numerous decisions that rely on judgments that cannot be specified in advance and for which objective criteria may be difficult to define (e.g., cost per year of life or patient measures of acceptability rather than just mortality). Often the data used by health services researchers have been collected primarily for other purposes and are being adapted for the research.
Moving from the results of a particular health services research study to implications for generic policy issues requires assessments of generalisabilty. The applicability of findings in health services research is more pervasive and harder to identify in health services research.
Some important features of health services research, such as methodology, funding, and venue, often differ from those of clinical and biomedical research. As the data and necessary resources are often readily available, health services research is generally far less expensive than biomedical or clinical research.
What research methods are used in health services research?
Health services researchers investigate complex health services using a wide range of quantitative and qualitative methods. Health services research often relies on study designs and data sources that are less straightforward than those in basic and clinical research studies including participant observation, the analysis of records both, written and in electronic databases, surveys and interviews.
Who conducts Health services research?
Health services research is carried out within a vast range of organisations including dedicated health services research institutes, universities, hospitals, GP practices and other community based health care organisations. A wide array of individuals, both scientists and non-scientists are often involved, each with different educational backgrounds and talents.
Reproduced with the kind permission of Cancer Council New South Wales.