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

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Introduction to Health Services Research : A Self-Study Course

Module 2: Brief History of Health Services Research (Page 10 of 40)

Quality of Care Considerations

Researchers also attended to the quality of medical care during the pre-war years.

Dr. Richard C. Cabot (1868-1939) and Dr. Ernest A. Codman (1869-1940) related the quality of the physician's care to patient outcomes.

Richard C. Cabot

Richard C. Cabot sitting at a microscope. Click to view a larger image.

Dr. Cabot employed new diagnostic techniques in his practice with patients, techniques that were sometimes ignored by his patients.

Ernest A. Codman

E.A. Codman developed one of the first attempts in outcomes research in 1914. Click for a larger view of EA Codman. In 1914, Dr. Codman developed a system to monitor surgical outcomes (the "end result"), one of the first attempts in outcomes research (Flook, 1973). Codman believed that every patient should be followed up "long enough to determine whether the treatment has been successful, and then to inquire 'if not, why not?' with a view to preventing similar failures..." (Codman, 1934).

His efforts to standardize hospital care led to the establishment of the American College of Surgeons and the Joint Commission on Accreditation of Hospitals (later JCAHO) (McLendon, 1990) .

Edgar Sydenstricker

Edgar Sydenstricker did one of the early epidemiological research studies in 1925. Click for a larger view of this image.In 1925 Edgar Sydenstricker (1881-1936) conducted an early epidemiological research study documenting the incidence of illness caused primarily by nutritional deficiencies in the general population of Hagerstown, Maryland.

View Key Projects and Milestones in Health Services Research.

Discussion Questions

  1. Why should we care about quality of care? Why did physicians in 1914 care about quality issues? Are the influences of Codman, Cabot and Sydenstricker felt today in the field? How do you know?
  2. Is outcomes research still important today, nearly 90 years after the work done by Codman? Explain.
  3. Certain Individuals in health services research have had a profound effect on the field and on librarians. Describe why the work of E.A. Codman was so important to the work librarians do today. Relate your answer to the work you do with health services researchers.
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