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 health services. A study is classified as health services research if it satisfies two criteria: it deals with some features of the structure, processes, or effects of personal health services; At least one of the features is related to a conceptual framework other than that of contemporary applied biomedical science.
(IOM, 1979:14)

Health services research . . .
is a field of inquiry that examines the roles of organization, finance, manpower, technology, and prevention in the provision of health care services, and their impact on utilization, cost, and quality of care. The field draws on many disciplines to address this breadth of research, including biostatistics, epidemiology, health economics, medicine, nursing, operations research, psychology, and medical sociology.
(Steinwachs, 1991:10)

Health services research . . .
is a field of inquiry that examines the impact of the organization, financing, and management of health care services on the delivery, quality, cost, access to, and outcomes of such services.
(Valentine, 1991)

Health Services Research: Selected Characteristics

The field of health services research presents a number of sizable challenges... For instance:

  • it lacks a widely adopted standard definition or conceptual structure, in part because of its markedly multidisciplinary nature;
  • it is conducted in many different settings (e.g., academia, government, clinical health care settings);
  • it has diverse purposes (e.g., empirical data collection, development of research instruments and methodologies, policy and operational decision making);
  • it focuses on several different geographic levels (e.g., international, national, state, county) and on broad populations as well as specific population subgroups;
  • it uses a particularly disparate set of theories, concepts, statistics, and devices and instruments derived from various disciplines; and
  • it uses a wide range of time frames for data collection and analysis (e.g., historical, most current, future trends).
    (IOM, 1991:6)

What is Health Services Research?

Health Services Research Components from the IOM Report, 1979

  • A focus on the health states of individuals or populations, or both;
  • review or analysis of health systems, health interventions, and the factors that influence health states;
  • a comprehensive set of variables involving health care techniques, practices, programs and policies; and
  • combination and integration of these variables in many ways, frequently emphasizing the nonbiological aspects of health and medical care (IOM, 1991:8)

Sources:

Flook, E.E. and Sanazaro, P.J. Chapter 1. Health Services Research: Origins and Milestones. In: E.E. Flook and P.J. Sanzaro, eds. Health Services Research and R&D in Perspective. Ann Arbor, MI: Health Administration Press, 1993.

Institute of Medicine. Health Services Research. Washington, D.C.: National Academy of Sciences, 1979.

Institute of Medicine. Improving Information Services for Health Services Researchers. A Report to the National Library of Medicine. 1991.

Institute of Medicine. Committee on Health Services Research: Training and Work Force Issues. Health Services Research: Workforce and Educational Issues. Washington, DC: National Academy Press, 1995.

Last, J.M., ed. A Dictionary of Epidemiology, 2d ed. New York:Oxford University Press, 1988.

Marshall, J.E. Introduction. Medical Care, 23:381-382, 1985.

Steinwachs,D.M. Health Services Research: Its Scope and Significance. In: P. Forman, ed. Promoting Health Services Research in Academic Health Centers. Washington, DC: Association of Academic Health Centers, 1991. p.23-72.

Valentine, W. Association for Health Services Research, Personal Communication, June 12, 1991.

White, K.L. Health Services Research: An Anthology. Washington, DC: Pan American Health Organization, 1992. (Scientific Publication; 534).