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Health Research Services: Health Care Advice
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Healthcare Research Sciences: Explanation
Healthcare is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. Healthcare is delivered by practitioners in allied healthcare, dentistry, midwifery (obstetrics), medicine, nursing, optometry, pharmacy, psychology and other healthcare professions. It refers to the work done in providing primary care, secondary care, and tertiary care, as well as in public healthcare. The structure of health broadly includes the facilities (e.g., hospitals and clinics), personnel (e.g., number of nurses and physicians), and technology that create the capacity to provide health services. Structural characteristics are expected to influence the quality of health services. One component in the accreditation of health facilities (e.g., hospitals, nursing homes) is the review of the adequacy of structural characteristics, including staffing, on-call resources, technology, and support services (laboratory, pharmacy, radiology). The structural resources of health facilities and organizations are the foundation upon which quality health services are provided. Healthcare services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of healthcare. They include personal and non-personal healthcare services. Healthcare services are the most visible functions of any healthcare system, both to users and the general public. Service provision refers to the way inputs such as money, staff, equipment and drugs are combined to allow the delivery of healthcare interventions. Improving access, coverage and quality of services depends on these key resources being available; on the ways services are organized and managed, and on incentives influencing providers and users.
The definition of Health Services Research--HSR is constantly evolving and has been defined differently by a number of thinkers and organizations. HSR is a multidisciplinary scientific field that examines how people get access to healthcare practitioners and healthcare services, how much care costs, and what happens to patients as a result of this care. Studies in HSR investigate how social factors, financing systems, organizational structures and processes, medical technology, and personal behaviors affect access to healthcare, the quality and cost of healthcare, 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 healthcare services. Often healthcare system has been defined with a reductionist perspective, for example reducing it to healthcare system. In many publications, for example, both expressions are used interchangeably. Some authors have developed arguments to expand the concept, indicating additional dimensions that should be considered: The systems should not be expressed in terms of their components only, but also of their interrelationships; The systems should include not only the institutional or supply side of the healthcare system, but also the population; The systems must be seen in terms of their goals, which include not only healthcare improvement, but also equity, responsiveness to legitimate expectations, respect of dignity, and fair financing, among others; The systems must also be defined in terms of their functions, including the direct provision of services, whether they are medical or public healthcare services, but also "other enabling functions, such as stewardship, financing, and resource generation, including what is probably the most complex of all challenges, the healthcare workforce.
The primary goals of HSR 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 access to care, in contrast to medical research, which focuses on the development and evaluation of clinical treatments. Healthcare services researchers come from a variety of specializations, including geography, nursing, economics, political science, epidemiology, public healthcare, medicine, biostatistics, operations, management, engineering, pharmacy, psychology, usability and user experience design. While healthcare services research is grounded in theory, its underlying aim is to perform research that can be applied by physicians, nurses, healthcare managers and administrators, and other people who make decisions or deliver care in the healthcare system. Approaches to HSR include: Implementation research: research focusing on public policy analysis, or the concerns of program managers regarding the effectiveness of specific healthcare interventions; Impact evaluation: research with emphasis on effectiveness of healthcare practices and organization of care, using a more narrow range of study methods such as systematic reviews of healthcare system interventions.
The field of HSR presents a number of sizable challenges... For instance: it lacks a widely adopted standard definition or conceptual structure, in part because of its markedly multidisciplinary nature; it is conducted in many different settings (e.g., academia, government, clinical healthcare settings); it has diverse purposes (e.g., empirical data collection, development of research instruments and methodologies, policy and operational decision making); it focuses on several different geographic levels (e.g., international, national, state, county) and on broad populations as well as specific population subgroups; it uses a particularly disparate set of theories, concepts, statistics, and devices and instruments derived from various disciplines; and it uses a wide range of time frames for data collection and analysis (e.g., historical, most current, future trends). HSR Components from the IOM Report, 1979 states: A focus on the healthcare states of individuals or populations, or both; review or analysis of healthcare systems, healthcare interventions, and the factors that influence healthcare states; a comprehensive set of variables involving healthcare techniques, practices, programs and policies; and combination and integration of these variables in many ways, frequently emphasizing the non-biological aspects of healthcare and medical care.
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