Health services research
Health services research (HSR), also known as health systems research or health policy and systems research (HPSR), is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. Studies in HSR investigate how social factors, health policy, financing systems, organizational structures and processes, medical technology, and personal behaviors affect access to health care, the quality and cost of health care, and quantity and quality of life. Compared with medical research, HSR is a relatively young science that developed through the bringing together of social science perspectives with the contributions of individuals and institutions engaged in delivering health services.
The primary 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. HSR is more concerned with delivery and access to care, in contrast to medical research, which focuses on the development and evaluation of clinical treatments.
Health services researchers come from a variety of specializations, including geography, nursing, economics, political science, epidemiology, public health, medicine, biostatistics, operations, management, engineering, pharmacy, psychology, usability and user experience design. While health services research is grounded in theory, its underlying aim is to perform research that can be applied by physicians, nurses, health managers and administrators, and other people who make decisions or deliver care in the health care system.
Approaches to HSR include:
- Implementation research: research focusing on public policy analysis, or the concerns of program managers regarding the effectiveness of specific health interventions;
- Impact evaluation: research with emphasis on effectiveness of health care practices and organisation of care, using a more narrow range of study methods such as systematic reviews of health system interventions.
Health Services Research by country
Many data and information sources are used to conduct health services research, such as population and health surveys, clinical administrative records, health-care program and financial administrative records, vital statistics records (births and deaths), and other special studies.
Claims data on USA Medicare and Medicaid beneficiaries are available for analysis. Data is divided into public data available to any entity and research data available only to qualified researchers. USA's Centers for Medicare and Medicaid Services(CMS) delegates some data export functions to a Research Data Assistance Center.
Colloquially, health services research departments are often referred to as "shops"; in contrast to basic science research "labs." Broadly, these shops are hosted by three general types of institutions - government, academic, or non-governmental think tanks or professional societies.
- U.S. Department of Veterans Affairs Award in Health Services Research
- Institute of Medicine, U.S.-based policy research organization
- Center for Surgery and Public Health, U.S. -based research institute at the Brigham and Women's Hospital (Harvard University Affiliate)
- Regenstrief Institute
- Institute for Healthcare Policy and Innovation, U.S. -based research institute at the University of Michigan (Founded in 2011, IHPI includes smaller centers focused on specific healthcare topics, such as the Center for Healthcare Outcomes & Policy
- Leonard Davis Institute of Health Economics, U.S.-based center for HSR at the University of Pennsylvania
Think Tank or Professional Society Sponsored
- Society of General Internal Medicine, U.S.-based professional organization in internal medicine research
- Commonwealth Fund, U.S.-based center for HSR
- Rand Corporation Health Division, U.S.-based center for HSR
Several government, academic and non-government agencies conduct or sponsor health services research, notably the Canadian Institute for Health Information and the Canadian Institutes of Health Research (i.e. the third pillar: "research respecting health systems and services").
Several registries are available for research use, such as Danish Twin Register or Danish Cancer Register.
- AcademyHealth. What is HSR?, June 2000.
- Sheikh K, et al. Building the Field of Health Policy and Systems Research: Framing the Questions. PLoS Med, 8(8): e1001073. Published August 16, 2011. Accessed August 22, 2011.
- Agency for Healthcare Research and Quality, February 2002.
- UX Magazine 14.3 - Healthy Designs, September 2014.
- "ResDAC". Retrieved 30 April 2013.
- "AHRQ.gov". Retrieved 30 April 2013.
- Frank, L. (2000). "Epidemiology. When an entire country is a cohort". Science 287 (5462): 2398–2399. doi:10.1126/science.287.5462.2398. PMID 10766613.
- Alliance for Health Systems and Policy Research, global partnership for health systems research
- Health-EU, portal on public health research of the European Union
- United States Veterans Affairs: Health Services Research & Development
- AcademyHealth, a U.S.-based professional development center for health services research
- Cedar Associates LLC, a U.S.-based center for clinical effectiveness decision analytical research