Health services research (HSR) became a burgeoning field in North America in the 1960s, when scientific information and policy deliberation began to coalesce. Sometimes also referred to as health systems research or health policy and systems research (HPSR), HSR is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. HSR utilizes all qualitative and quantitative methods across the board to ask questions of the healthcare system. It focuses on performance, quality, effectiveness and efficiency of health care services as they relate to health problems of individuals and populations, as well as health care systems and addresses wide-ranging topics of structure, processes, and organization of health care services; their use and people's access to services; efficiency and effectiveness of health care services; the quality of healthcare services and its relationship to health status, and; the uses of medical knowledge.
Studies in HSR investigate how social factors, health policy, financing systems, organizational structures and processes, medical technology, and personal behaviors affect access to health care, the quality and cost of health care, and quantity and quality of life. Compared with medical research, HSR is a relatively young science that developed through the bringing together of social science perspectives with the contributions of individuals and institutions engaged in delivering health services.
Goals
The primary 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. HSR is more concerned with delivery and high quality access to care, in contrast to medical research, which focuses on the development and evaluation of clinical treatments.
Health services researchers come from a variety of specializations, including geography, nursing, economics, political science, epidemiology, public health, medicine, biostatistics, operations, management, engineering, pharmacy, psychology, usability and user experience design. While health services research is grounded in theory, its underlying aim is to perform research that can be applied by physicians, nurses, health managers and administrators, and other people who make decisions or deliver care in the health care system. For example, the application of epidemiological methods to the study of health services by managers is a type of health services research that can be described as Managerial epidemiology.
Approaches
A common distinction of approaches to HSR is between levels of analysis: Macro (architecture and oversight of systems) Meso (functioning of organizations and interventions) Micro (the individual in the system)
Another distinction can be made between the intent of the research question as either normative/evaluative or exploratory/explanatory.
Collective leadership
Leadership that includes all members of staff and patients in a healthcare setting is referred to as "collective leadership". The idea is that all people involved in healthcare, including those at the receiving end such as patients and caregivers/families, share responsibility for decision making, performance of the healthcare system, and successes. Collective leadership is based on the concept that all stakeholders share viewpoints and knowledge in order to keep up with rapid technological changes, patient-centered outcomes, and the increasing need for specialization in healthcare. The effectiveness of this approach is still being understood and there is no strong evidence to suggest that this approach improves clinical performance, mortality of inpatients, or other outcomes such as staff absences.