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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Module 1: What is Health Services Research (HSR)? (Page 7 of 11)

Definitions of Health Services Research

The field of health services research has been defined by many different organizations. In a nutshell, health services researchers investigate three major aspects of health care: access to care, the quality of the care, and its cost. Health services researchers attempt to evaluate the effects and outcomes of the health care "system" on people's health.

The following definitions have been used by various organizations. The newest definition is now five years old, the oldest over twenty-five years. This page provides a link to the organizations providing definitions. The core areas of interest page in this module contains a set of definitions related to access, quality, cost and evaluation.

Key Definitions of Health Services Research

Agency for Healthcare Research and Quality, 2002
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)
AcademyHealth, 2000
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. (AcademyHealth, 2000)
The Institute of Medicine, 1994)
HSR is a multi-disciplinary field of inquiry, both basic and applied, that examines access to, and the use, costs, quality, delivery, organization, financing, and outcomes of health care services to produce new knowledge about the structure, processes, and effects of health services for individuals and populations. (IOM, 1994)
Last Dictionary of Epidemiology and MeSH, 1980
The integration of epidemiologic, sociologic, economic, and other analytic sciences in the study of health services. HSR is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim is evaluation, particularly in terms of structure, process, output, and outcome. (NLM, 1980)
National Library of Medicine (NLM) Collection Development Manual
The scientific study of the effect of health care delivery and management on health care access, quality, and cost.

Related Definitions

Health Technology Assessment (HTA)
Health technology assessment is evaluation of the cost, efficacy, cost-effectiveness, patterns of use, and the ethical, economic, and social consequences of the use of a medical technology. Broadly, it refers to safety, cost-effectiveness, patient preference, and quality of life. More narrowly, HTA refers to apparati, instruments, implements, contrivances, machines, implants, devices, etc., and HTL starts with safety and efficacy.
Clinical Practice Guidelines (CPG) 
Clinical practice guidelines are a set of directions or principles to assist the health care practitioner with patient care decisions about appropriate diagnostic, therapeutic, or other clinical procedures for specific clinical circumstances. CPG Producers include government agencies (e.g., AHCPR, NIH, CDC, SAMHSA, Prev. Services TFs), professional associations (e.g., AMA, ACP, ACOG, AAHP), insurers, Health Maintenance Organizations/Medical Care Organizations, and academic med centers, hospitals clinics, large group practices, to name a few .
Meta-Analysis
A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc.

Discussion Questions

  1. Over time the definitions of health services research have become more refined and more precise. As you read over the various definitions listed above which is your personal favorite? Why? If you were rewriting the definition, is there anything else that you would include?
  2. How do you define access, quality, cost and evaluation of the effects and outcomes of the health care "system" on people's health in light of your current and past work with health services researchers?
  3. In the 1994 IOM report, emphasis is put on several facts: that health services research is a multidisciplinary field, that it looks into basic and applied research, that it states that understanding as well as knowledge is critical for "expanding the theoretical and conceptual frameworks for conducting, interpreting, and applying empirical research", and that population health as well as individual health is relevant for research. How critical is it for a librarian to gain an understanding of all the fields and knowledge that underly these few concepts? Is gaining an understanding of these underlying concepts easy or difficult?

 

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