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

"Health sciences research is the scientific investigation of the care of individuals and the population with products and services relevant to health under routine daily conditions" (Health Services Research working party with the scientific advice of the Federal Medical Council 2004: 2). Health services research investigates the last level of the innovation transfer in the practice of patient care by Pfaff (2003) and is also referred to as the "last mile". Current terms used on an international level are "Outcomes Research" and "Health Services Research" (Lohr & Steinwachs 2002).

Health services research that can be considered part of the health system research focuses in particular on the micro levels of the health system (Schwartz & Busse 2003). In concrete terms, this refers to the investigation of patient and health care in hospitals, doctors' practices and other health establishments (Schmacke 2004). Health care encompasses the support, care, diagnosis, treatment and follow-up of patients by medical and non-medical staff in health care establishments from both a medical and psychosocial perspective. The term health care covers virtually all forms of patient care and all types of prevention and strategies to promote health.

This applies to measures for individuals and populations alike (Pfaff 2003). However, meso-levels and macro-levels of the health care system (e.g. hospitals, doctors' associations or self-help organizations) can be the subject of issues relevant to health care services research as they influence outcomes and the health services situation within the health profession. Lohr and Steinwachs (2002) provide a comprehensive overview of the subjects covered in health services research and sub-divide these into individuals, families, organizations, institutions, communes and populations.

Health services research can be divided into two key areas: 1.) health services research based on principles and 2.) health services research geared towards application. The primary aim of health services research based on principles is to describe the various elements of complex, differentiated health services systems and to clarify potential causal connections. Lohr and Steinwachs (2002) define health services research in this context as a multidisciplinary study, the aim of which is to investigate how social factors, financial systems, organizational structures and processes, health technologies and individual behavior affect access to the health care system, the quality and cost of care and finally health and well being. Conversely, research health services targeted towards application are involved in developing innovative health services concepts and structures (concept development) based on the knowledge generated through basic research, evaluating the implementation of these new concepts under routine, daily conditions at the same time (concomitant research) and finally researching effectiveness (outcome research).

The task of health services research is thus to use scientifically sound methods to identify health services deficits, to contribute to the development and implementation of new health services concepts and to evaluate their effectiveness. The investigation of health service needs (input), health service structures and processes (throughput), the services rendered (output) and gains in health or quality of life (outcome) as well as the direct relevance of research results to health policy decision making are the main characteristics of health services research.

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

Das systemtheoretische Modell des Versorgungssystems (Pfaff, 2003)

In this way, health services research lays the scientific foundations for continuous improvements in disease and health care and optimal mid- to long-term achievement of the three central health services targets, namely patient orientation, quality and economic efficiency.

The object of health services research is thus the medical and psychosocial care of patients and the professional prevention of disease and promotion of health in healthy subjects.