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Due to the complexities of health care services and systems, investigating and interpreting the use, costs, quality, accessibility, delivery, organization, financing, and outcomes of health care services is key to informing government officials, insurers, providers, consumers, and others making decisions about health-related issues.
Health services researchers examine the access to care, health care costs and processes, and the outcomes of health services for individuals and populations. The field of health services research HSR is relied on by decisionmakers and the public to be the primary source of information on how well health systems in the United States and other countries are meeting this challenge.
This was expanded upon in by AcademyHealth, the professional organization of the HSR field, with the following definition, which broadly describes the scope of HSR: 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. These include changes in Medicare and Medicaid coverage, disparities in access and utilization of care, innovations in private health insurance e.
As new diagnostic and treatment technologies are introduced, HSR examines their impact on patient outcomes of care and health care costs.
The definition of HSR also highlights the importance of examining the contribution of services to the health of individuals and broader populations. These reports tell us that the American quality of care is inconsistent and could be substantially improved.
For example, HSR methods have been developed to describe doctor-patient communication patterns and examine their impact on patient adherence, satisfaction, and outcomes of care.
Prospective payment of hospitals, nursing homes, and home health care by Medicare became possible with the development of robust case-mix measurement systems. History of Health Services Research The history of HSR is generally considered to have begun in the s and s with the first funding of grants for health services research focused on the impact of hospital organizations.
Public Health Services to address concerns with access to health services, quality of care, and costs. The Center funded demonstration projects to measure quality and investigator-initiated research grants.
InCongress created the Agency for Health Care Policy and Research and broadened its mission to focus attention on variations in medical practice, patient outcomes of care, and the dissemination of evidence-based guidelines for the treatment of common disorders.
AHRQ provides Federal leadership for the field, investing in methods for quality measurement, development of patient safety methods, and health information technology e.
The diversification of funding comes, in part, from the recognition that HSR is important in managing health care systems, such as the Veterans Health Administration, and provides essential information on the translation of scientific discoveries into clinical practice in American communities, such as those funded by National Institutes of Health.
Funding by private foundations has a significant role and complements Federal funding.
Other private funding sources include the health care industry, for example, pharmaceutical companies, health insurers, and health care systems. Goals for Health Services and Patient Outcomes The goal of health services is to protect and improve the health of individuals and populations.
In a landmark report, Crossing the Quality Chasm: Patients should not be harmed by health care services that are intended to help them. Subsequent research has found medical errors common across all health care settings.
Effective care is based on scientific evidence that treatment will increase the likelihood of desired health outcomes. Evidence comes from laboratory experiments, clinical research usually randomized controlled trialsepidemiological studies, and outcomes research.Topics of recent issues Sociology of literary creativity (vol.
xix, n o. 4) Theory, training and practice in m a n a g e m e n t (vol. x x, n o.
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