Health Services Research in Improving the Delivery of Care for Patients with Cardiovascular Diseases: Moving From Observation to Innovation to Action.

Abstract

Health services research (HSR) is a multidisciplinary field of scientific inquiry that examines how people access health care, how that care is delivered, how much it costs and, ultimately, what happens to patients as a result of this care. Put simply, it asks what works, in whom, at what cost, and under what circumstances.1 Accordingly, HSR can provide important insights into the current delivery of health care, identify areas where current care falls short, and guide interventions for improvement in care delivery. HSR has a particularly valuable role in cardiovascular care. The prevalence, associated morbidity and mortality, and large financial costs incurred by cardiovascular disease make its impact on health and medical costs significant. As a result, HSR insights into improvement opportunities for cardiovascular care delivery can lead to large gains in healthcare value. For example, HSR insights into acute stroke care deficiencies led to the American Heart Association Get With the Guidelines Stroke quality improvement program. Over a 5-year period, the program significantly increased adherence to best acute stroke care practices.2 Another successful application of HSR methodologies in cardiovascular disease has been to ST-elevation myocardial infarction door-to-balloon times.3 HSR investigators identified significant barriers …