Health services research
What is health services research? Health services research

Health services research is a multidisciplinary field of research that analyses supply structures and processes in health care paying attention particularly on individual and population based per-spectives. In doing so health services research focusses on adequacy of treatments, improvements of supply and the complexity regarding context and intervention (Schrappe & Pfaff, 2017).

“Health services research is the scientific study of the treatment of the individual and of the population with products and services relevant to health in everyday circumstances” (Health Services Research Work Group at the Scientific Advisory Board of the German Medical Association, 2004: 2). Health services research investigates the last step in innovation transfer towards practical patient care, also called the “last mile” in the words of Pfaff (2003). The terms “Outcomes Research” and “Health Services Research” are common internationally (Lohr & Steinwachs, 2002).

Health services research, which can be seen as a branch of health system research, focusses in particular on the micro level of the health system (Schwartz & Busse, 2003). Specifically, it deals with the investigation of health care and care of the ill in hospitals, doctors’ surgeries and other health facilities (Schmacke, 2004). In it, health care includes the support, care, diagnosis, treatment and also the aftercare of patients by medical and non-medical providers of health services both in a medical and in a psychosocial context. The term health care includes not only all forms of medical care but also all forms of prevention and health promotion.

This applies both to individually based and population based measures (Pfaff 2003). Even the meso and macro level of the health system (e.g. health insurance funds, medical associations or self-help groups) can indeed be the subject of health service research-based surveys, since they help influence performance and the health care situation in the health sector. Lohr & Steinwachs (2002) come up with a very comprehensive definition of the object of investigation of health services research, and subsume under this term individuals, families, organisations, institutions, municipalities and populations.

Health services research can generally be divided up into two categories: 1.) fundamental health services research and 2.) application-oriented health services research. Fundamental health services research primarily aims to describe the various elements of the complex and differentiated care system and explain any possible causal connections. Lohr & Steinwachs (2002) define health services research in this context as a multidisciplinary science, whose aim it is to analyse how social factors, financing systems, organisational structures and processes, health technologies and individual behaviour patterns influence access to the health system as well as quality and the cost of health care and ultimately health and well-being. Application-oriented health services research, on the other hand, aims to develop innovative concepts and structures on the basis of the knowledge generated by fundamental research (concept development), to evaluate along the way how these new concepts can be implemented under normal everyday circumstances (accompanying research), and finally investigate its effectiveness (outcome research).

Subsequently, the goal of health services research is to identify, by way of a scientifically sound procedure, health care deficits, to develop and implement new health care concepts and to evaluate their effectiveness. The investigation of the demand for care (input), of the health care structures or processes (throughput), of the health services rendered (output) and of the gain in health and quality of life (outcome) as well as the direct health-based relevance to decision-making of the outcome of research are characteristics of health services research.)

Systems theory-based models of healthcare system (Pfaff, 2003)

Systems theory-based models of healthcare system

In this way, the scientific foundation for a continuous improvement of medical and health care can be laid, thus arriving, in the medium to long term, at the three central aims of health care: patient orientation, quality and viability, as far as possible in equal measure.

The subject of health services research is therefore the medical and psychosocial care of the ill as well as professional prevention and health promotion among the healthy.

Literature:

 

  • Arbeitskreis Versorgungsforschung beim wissenschaftlichen Beirat der Bundesärztekammer (2004): Definition und Abgrenzung der Versorgungsforschung. http://www.definitionen.versorgungsforschung.net/ (Letzter Zugriff: 15.03.2005).
  • Lohr, K. N. & Steinwachs, D. M. (2002). Health Services Research: An Envolving Definition of the Field. Health Services Research, 37, 15-17.
  • Pfaff, H. (2003). Versorgungsforschung - Begriffsbestimmung, Gegenstand und Aufgaben. In H. Pfaff, M. Schrappe, K. W. Lauterbach, U. Engelmann, & M. Halber (Eds.), Gesundheitsversorgung und Disease Management. Grundlagen und Anwendungen der Versorgungsforschung (pp. 13-23). Bern: Verlag Hans Huber.
  • Schmacke, N. (2004). Versorgungsforschung - auf dem Weg zu einer Theorie der "letzten Meile". Gesundh.ökon.Qual.manag., 9. Jahrgang, Heft 3, 167-171.
  • Schrappe, M., Pfaff, H.: „Versorgungsforschung vor neuen Herausforderungen: Konsequenzen für Definition und Konzept“, in: „Monitor Versorgungsforschung 04/17, S. 49-53, doi: 10.24945/MVF.04.17.1866-0533.2025
  • F.W. Schwartz, R. Busse (2003): Denken in Zusammenhängen: Gesundheitssystemforschung. In: Schwartz, F.W., Badura, B., Busse, R. u.a. [Hrsg.]: Public Health Buch. Urban & Fischer Verlag, München, Jena, 518-545.