Health Services Research, Part 1: Introduction
by Susan Dess, 2.27.17
What Is It?
Building on earlier definitions of health service research (HSR) developed by the Institute of Medicine (IOM) of the National Academy of Sciences the Association for Health Services Research (AHSR) describe the field as:
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.
HSR studies can focus on the outcomes, structure, or process of personal health care. For example, the Center for Health Services Research (CHSR) at the University of Texas Health Science Center at Houston describes the following major health services research areas:
> Clarify the costs and benefits of health promotion, protection, prevention, treatment and rehabilitation services (Outcomes)
> Identify and evaluate financing and service delivery initiatives to better serve uninsured, low-income populations (Structure)
> Identify and evaluate relevant federal, state and local health policy related to these issues (Process)
Provider organizations and health plans are charged with assessing health outcomes, while advocacy groups and governmental agencies may tend to be focused on studying the structure and processes or health services delivery which are directly related to policy-making.
Why It's Important Now
HSR focused on generating health outcome data for provider agencies and health plans will only increase in importance in the future as funders develop heightened expectations for documentation and reporting of health outcomes. Provider agencies and health plans that bid on competitive business will be required to explain how they plan to measure health when writing responses to Requests for Proposals. States that pursue Value-Based Purchasing initiatives will expect contracted health plans to demonstrate health outcomes to receive incentive payments.
However, when the principles of applied social science methods are not properly followed HSR studies often do not generate meaningful and useful data. As survey research methods are a primary way of gathering large amounts of data about a population of individuals receiving health services efficiently and in a cost-effective manner, many provider organizations and health plans can benefit from developing stronger capacity in survey research for measuring health outcomes.
Focusing specifically on developing surveys for HSR studies designed to measure health outcomes, this series of brief articles discusses:
> Various types of health-related surveys and outcomes that can be measured
> Creating meaningful research questions
> Conceptualizing and operationalizing variables
> Developing sophisticated survey questions
As an experienced health care professional, Susan (Sue) Dess brings a wide range of experiences to Crestline. Her 15 year administrative and executive management background spans the operations of both managed care and provider organizations.
Additionally, Sue spent 25 years as an Emergency Room and Intensive Care Registered Nurse, further rounding out her ability to understand the "big picture." Sue is intimately involved with each Crestline project, collaborating closely with consultants and clients.