Field Of Health Services Research Research Articles

German primary care data collection projects: a scoping review

BackgroundThe widespread use of electronic health records (EHRs) has led to a growing number of large routine primary care data collection projects globally, making these records a valuable resource for...

Development and maturation of the occupational health services research field in the United States over the past 25 years: Challenges and opportunities for the future.

Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.

Patient- and community-centered approaches as the cornerstone of health services evaluation in the 21st century.

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The Dartmouth Atlas of Health Care – bringing health care analyses to health systems, policymakers, and the public

In 1996, the Dartmouth Atlas of Health Care pioneered the dissemination of policy-relevant population-based measurement and analysis that revealed both weaknesses and opportunities in the United States health care system by focusing on regional and hospital variation in utilization, quality, and costs. Built on a growing foundation of peer-reviewed research, the Atlas produced more than 40 reports over the next 25 years addressing a wide range of pressing health care problems. The project’s publications and website also provided regional and hospital-specific data to health systems, governmental jurisdictions, health care stakeholders, and the public. The Atlas’ methods and its conceptual framework have been widely disseminated in North America and the United Kingdom, and, more recently, in Europe, South America, Asia, and Oceania. This paper discusses the origins of the Atlas from Dr. John Wennberg’s early studies, the scaling up of data, methods, and policy-relevant findings, and its incorporation into the more general fields of health services research, policy development, and clinical improvement.

Web search data as health data? : Geographic differences, temporal trends, and topics of interest from internet search engine analyses in Germany

HintergrundDie eingeschränkt zeitnahe, kostengünstige und regionale Verfügbarkeit von Daten im Gesundheitswesen gilt als einer der limitierenden Faktoren für zeitgerechte Analysen im Bereich der Versorgungsforschung und damit für die Gesundheitsversorgung der allgemeinen Bevölkerung. Deshalb geraten zunehmend Internetsuchmaschinenanalysen in den Fokus.FragestellungWelchen Beitrag können Daten zum Internetsuchvolumen zu verschiedenen Erkrankungen in der Gesundheitsversorgung der deutschen Bevölkerung leisten? Wo liegt das Potenzial, und wo gibt es Grenzen?Material und MethodenEs erfolgten die Aufbereitung der aktuellen Literatur sowie eine selektive Übersicht der in den letzten 4 Jahren veröffentlichten Suchmaschinenanalysen zu dermatologischen, allergologischen und infektiologischen Erkrankungen in Deutschland.ErgebnisseDurch die Analyse von Suchmaschinendaten konnten zeitliche Entwicklungen wie Saisonalität, Monate mit dem höchsten Suchinteresse und geografische Unterschiede auf nationaler, Bundesländer- und Städteebene abgebildet und Interessenschwerpunkte bezüglich eines die Krankheit betreffenden Themas (z. B. Hautkrebs am Auge oder analer Juckreiz) aufgezeigt werden. Darüber hinaus fanden manche Studien einen Zusammenhang zwischen dem Suchvolumen und externen Faktoren (z. B. Temperatur, ärztliche Versorgungsstruktur) sowie zu registrierten Fällen (z. B. Hautkrebs, Borreliose).SchlussfolgerungInternetsuchmaschinendaten liefern als nahezu in Echtzeit verfügbare Datenquelle unter Berücksichtigung der aufgezeigten Fallstricke ein räumlich-zeitliches Abbild hinsichtlich der Bedürfnisse der internetnutzenden Bevölkerung. Sie können besonders nützlich in Situationen sein, in denen traditionelle Gesundheitsdaten begrenzt oder nicht vorhanden sind.Zusatzmaterial onlineDie Online-Version dieses Beitrags (10.1007/s00105-021-04918-x) enthält eine zusätzliche Tabelle. Beitrag und Zusatzmaterial stehen Ihnen im elektronischen Volltextarchiv auf https://www.springermedizin.de/der-hautarzt zur Verfügung. Sie finden das Zusatzmaterial am Beitragsende unter „Supplementary Information“.

Practical Guide to Implementation Science for Surgical Oncologists: Case Study of Breast Cancer Short Stay Program.

Long lags exist in adoption and uptake of evidence-based interventions into real-world clinical practice based on oncology clinical trial results. Implementation science (IS) is a distinct field of health services research that aims to understand the barriers related to adoption of evidence-based guidelines and research in clinical practice. Use of IS study design, methods, and outcomes can be elusive to surgical oncologists despite the tremendous need for the application of IS to bridge the evidence-to-practice gap. This report describes key components of high-quality IS. Herein, we illustratehow IScan be used in surgical oncology practice.Examples from implementation of the breast cancer Short Stay Program (SSP)in Netherlands is used to illustrate IS methods. Specific funding and training opportunities in implementation science are described in detail. Use of IS in surgical oncology can help improve the uptake of evidence based medicine.

“Slow science” for 21st century healthcare: reinventing health service research that serves fast-paced, high-complexity care organisations

PurposeThe purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick.Design/methodology/approachThe paper is structured in three parts. It first reviews the field of health services research and the approaches that dominate it. It then considers the healthcare research approaches whose principles and methodologies are more aligned with “slow science” before presenting a description of a “slow science” project in which the authors are currently engaged.FindingsCurrent approaches to health service research struggle to offer adequate resources for resolving frontline complexity, principally because they set more store by knowledge generalisation, disciplinary continuity and integrity and the consolidation of expertise, than by engaging with frontline complexity on its terms, negotiating issues with frontline staff and patients on their terms and framing findings and solutions in ways that key in to the in situ dynamics and complexities that define health service delivery.Originality/valueThere is a need to engage in a paradigm shift that engages health services as co-researchers, prioritising practical change and local involvement over knowledge production. Economics is a research field where the products are of natural appeal to powerful health service managers. A “slow science” approach adopted by the embedded Economist Program with its emphasis on pre-implementation, knowledge mobilisation and parallel site capacity development sets out how research can be flexibly produced to improve health services.

The Swiss Learning Health System: a national initiative supporting evidence-informed decision-making

Abstract Issue Over the last years, there has been an ever-increasing interest in how to promote and support uptake of evidence and evidence-informed decision-making in health-systems related policy and practice. However, only few efforts have been made that aim at fully leveraging the knowledge and expertise of bigger networks to address this issue more comprehensively. Description of the problem Also, in Switzerland, the need to address this matter has been increasingly emphasized by actors in the health system. In particular, the lack of comprehensive coordination efforts in the field of health services research, and subsequent knowledge translation activities, has been stressed. Results In response, the Swiss Learning Health System (SLHS) was established as a nationwide project in 2017, currently involving 10 academic partners. One of the overarching objectives of the SLHS is to bridge research, policy, and practice by providing an infrastructure that supports learning cycles. Learning cycles enable the continuous integration of evidence into policy and practice by: continuously identifying issues relevant to the health system, systemizing relevant evidence, presenting potential courses of action, and revising and reshaping responses. Key features of learning cycles in the SLHS include the development of policy/evidence briefs that serve as a basis for official stakeholder dialogues, which are structured dialogues during which the best course of action is discussed and evaluated. Issues that are identified to be further pursued are monitored for potential implementation and eventually evaluated to inform new learning cycles and to support continuous learning within the system. Lessons The SLHS is an important mechanism to institutionalize learning cycles within the Swiss health system by leveraging the expertise and knowledge of a comprehensive network, going beyond individual initiatives, and to respond effectively to newly occurring health system challenges. Key messages The Swiss Learning Health System is the first nationwide project that aims to establish learning cycles that support evidence-informed decision-making in health-system-related policy and practice. The Swiss Learning Health System is an infrastructure that supports the continuous flow of evidence into policy and practice, providing a mechanism to respond to occurring health system challenges.

Intersections of machine learning and epidemiological methods for health services research.

The field of health services research is broad and seeks to answer questions about the health care system. It is inherently interdisciplinary, and epidemiologists have made crucial contributions. Parametric regression techniques remain standard practice in health services research with machine learning techniques currently having low penetrance in comparison. However, studies in several prominent areas, including health care spending, outcomes and quality, have begun deploying machine learning tools for these applications. Nevertheless, major advances in epidemiological methods are also as yet underleveraged in health services research. This article summarizes the current state of machine learning in key areas of health services research, and discusses important future directions at the intersection of machine learning and epidemiological methods for health services research.

Qualitative Research Methodology and its Scope in Health Services Research

Health services research is a multidisciplinary field which involves policy makers, health care providers, as well as quality outcomes professionals of the health services provided in an organizational setting to name some. Using qualitative research methodology to get insights of both the provider and patient experience down the pipeline can help strengthen what is lacking. Bridging the gap of translation research by not just surveys 1 might be an appropriate research methodology, however, inclusion of case studies, ethnographies might help stakeholders in the field, to visualize in depth phenomenon occurring in health services research field. Telly medicine, commercial digital health status trackr might be some of the inetrventions to improvise health care services, however, knowing what are the actual needs at individual level might efficiently help in redistribution of resources or policy laws. Recruiting for clinical trials through story telling communication technology2,3, might help in recruitment for novel drug therapies to explore possibilities, however, exploring the barriers to enroll for the clinical trials, or why the drug might work effectively in some cultural population and why not on others, can only be efficiently explored through qualitative research methodologies.

The Junior Research Academy 2017 of the German Research Foundation (DFG) - Promotion of Young Researchers in Health Services

The fourth Junior Research Academy in Health Services Research was once again funded by the German Research Foundation (DFG) in 2017. The academy was initiated by the Centre for Health and Society (chs) in Düsseldorf with the participation of the Centre for Health Services Research Cologne (ZVFK), the Research Centre for Health Communication and Health Services Research (CHSR) of the Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy of the University Hospital Bonn, the Interdisciplinary Centre for Health Services Research (IZVF) in Witten and the Institute for Health Services Research and Clinical Epidemiology (IVE) of the University Marburg. The aims of the Junior Research Academy are for imparting skills in the development and elaboration of innovative project ideas, to increase the number of proposals from the field of health services research to the DFG, to strengthen basic research within health services research in Germany and to network the scientific community. Young researchers from all over Germany were eligible to apply for participation by submitting an application in the form of a research proposal. A total of 83 applications were received. The 21 most promising applicants (14 women and 7 men) were selected in a 2-stage review process; 20 of these completed the Junior Research Academy program. After a one-day preparatory workshop, the preparation and review of a sample application, an academy week and a finalisation phase, all applications were submitted to the DFG on time. Of these proposals, 9 were funded. The first alumni meeting of the DFG Junior Research Academy took place in Düsseldorf in July 2019.

Wer braucht Versorgungsforscher/innen? Eine Bestandsaufnahme zum Berufsbild anhand von Stellenanzeigen

IntroductionHealth services research is an interdisciplinary field mainly defined by its topic rather than a distinct set of theories and methods. However, a specific demand for health services researchers can be observed. Yet, only few findings on the occupational profile are available, mainly indirectly drawn from educational programs within the field. Our aim was to assess the occupational profile “health services researcher” from the perspective of the labor market in Germany. MethodsA 6-month systematic search for job offers containing the term “health services research” was performed. Afterwards, job offers were excluded that focused on assistance (e. g. no academic degree required) and/or did not contain health services research content. Then all job offers, excepting professorships, were excluded that primarily required another professional degree (e. g. a medical degree). Combining induction and deduction, a coding table was developed containing the following main codes: a) employer type, b) job focus, c) labor relations, d) job profile, e) qualifications required, and f) relation to health services research. ResultsOf the 137 job offers identified, 113 remained after applying the exclusion criteria. More than 50 % (n=62) of the employers are universities (n=49) or universities of applied sciences (n=13), followed by corporations (n=37), public services and related sectors (n=12), and hospitals (n=2). The main activities listed were: a) science and research (60.2 %), b) representation of interest (30.6 %), c) data management (3.7 %) and d) healthcare management (1.9 %). Interest or experience in health services research was mandatory in 62.6 % of the job offers, competencies in quantitative and qualitative research methods in 45.8 % and 18.8 %, respectively. DiscussionNone of the job offers examined was exclusively directed towards health services researchers. However, specific qualifications related to health services research were sought by employers, mostly in research projects. The main qualifications demanded were research methods skills and knowledge of the German healthcare system. ConclusionHealth services research is a term which is used in job offers on the German labor market and is associated with multiple academic disciplines. At the same time, an institutionalization process can be observed, most prominently within the advertised professorships. This may lead to a consolidation of career paths in the future. The results of this study might inform educational programs in the field of health services research and may be of interest to graduates looking for employment.

Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

Group Discussions in Health Services Research - Part 2: Reflections on The Concept of Group, Moderation and Analysis of Group Discussions as well as Online Group Discussion

This article is the second of 2 articles on group discussions in health services research, written by the Qualitative Methods Working Group of the German Network for Health Care Research (DNVF). It starts with theoretical considerations on the concept of groups, and provides specific knowledge about groups in general and the behaviour of individual group members in particular, which is relevant for the design and interpretation of interaction processes in the group context. The following sections deal with the processuality of group discussions, moderation styles and techniques as well as reflections on possible subjects and methods of analysis. Presentation of results and text passages which unveil the interaction structure of several discussion participants are also discussed here. Finally, insights into the special features, potentials and challenges of group discussions via online platforms are provided. Together, the two articles provide an overview of the most important aspects of the application of group discussions in the field of health services research.

Occurrence and nature of questionable research practices in the reporting of messages and conclusions in international scientific Health Services Research publications: a structured assessment of publications authored by researchers in the Netherlands

ObjectivesExplore the occurrence and nature of questionable research practices (QRPs) in the reporting of messages and conclusions in international scientific Health Services Research (HSR) publications authored by researchers from HSR...

Advancing the Delivery of Communication Sciences and Disorders Services Through Research: The Promise of Health Services Research

Purpose Traditional efficacy research, or research that studies interventions in controlled settings, can be difficult to translate to real-world clinical settings. In this article, we introduce the field of health services research (HSR) as 1 possible tool to aid this translation. HSR is a field of research that examines and intervenes in the use, cost, quality, delivery, organization, and outcomes of clinical interventions and services in the real-world setting. The complexity of the world outside the clinic walls is accounted for in HSR methods and data sources. As such, HSR often requires collaboration of stakeholders, including patients, caregivers, clinicians, and policy makers. These stakeholders are often engaged throughout the research process, from selecting research questions to disseminating results. HSR brings together researchers from multiple disciplines, including sociology, health economics, epidemiology, and implementation science, among others. The outcomes of HSR can inform policy changes both locally and nationally. To clarify the scope and impact of HSR, we present examples of HSR-based research on communication between patients with communication disorders and health care providers. Conclusions HSR is a critical tool for clinicians and researchers in the discipline of communication sciences and disorders who are committed to improving the lives and health of persons with communication disorders.

What's happening in Innovations in Care Delivery

Innovations in Care Delivery strives to highlight articles that feature advances in care delivery in our Editor's Blog, Editor's Top Five Recommended Reading, and Latest Articles sections. Periodically, we also include interviews with leaders in the field of health services research.

Exploring the synergies between focused ethnography and integrated knowledge translation

BackgroundIssues with the uptake of research findings in applied health services research remain problematic. Part of this disconnect is attributed to the exclusion of knowledge users at the outset of a study, which often results in the generation of knowledge that is not usable at the point of care. Integrated knowledge translation blended with qualitative methodologies has the potential to address this issue by working alongside knowledge users throughout the research process. Nevertheless, there is currently a paucity of literature about how integrated knowledge translation can be integrated into qualitative methodology; herein, we begin to address this gap in methodology discourse. The purpose of this paper is to describe our experience of conducting a focused ethnography with a collaborative integrated knowledge translation approach, including the synergies and potential sources of discord between integrated knowledge translation and focused ethnography.MethodsWe describe the specific characteristics and synergies that exist when using an integrated knowledge translation approach with focused ethnography, using a research exemplar about the experiences of frail, older adults undergoing a transcatheter aortic valve implantation.ResultsEmbedding integrated knowledge translation within focused ethnography resulted in (1) an increased focus on the culture and values of the context under study, (2) a higher level of engagement among researchers, study participants and knowledge users, and (3) a commitment to partnership between researchers and knowledge users as part of a larger programme of research, resulting in a (4) greater emphasis on the importance of reciprocity and trustworthiness in the research process.ConclusionsEngaging in integrated knowledge translation from the outset of a study ensures that research findings are relevant for application at the point of care. The integration of integrated knowledge translation within focused ethnography allows for real-time uptake of meaningful and emerging findings, the strengthening of collaborative research teams, and opportunities for sustained programmes of research and relationships in the field of health services research. Further exploration of the integration of knowledge translation approaches with qualitative methodologies is recommended.

Health Services Research Facilities at German Universities

So far, there is a lack of knowledge about the situation of health services research at German universities. The aim of the present study is to provide data about health services research facilities and teaching activity in German universities. An online survey of German university lecturers in the field of health services research was conducted in 2017. The semi-standardized survey contained 25 factual questions. The quantitative responses were analyzed descriptively using IBM SPSS Statistics 24. The open questions were analyzed by content analysis. N=42 lecturers took part in the survey (response rate 97.6%). Health services research methods are subject to human medicine as well as health science programs. Specific programs in health services research were identified at 3 locations. The doctoral and postdoctoral opportunities in the field of health services research are heterogeneous. In the field of research methods, quantitative methods dominate, in particular patient-reported outcome research with primary data. The most frequently mentioned interdisciplinary cooperation is with biometry/epidemiology and health economics. There is a need for further training for health services researchers in terms of specific terminology, framework models, data sources, evaluation methods, data protection aspects, and health policy aspects. In addition to the training of the health services researchers, it is important to improve the doctoral and habilitation opportunities in the field of health services research in order to encourage and support young scientists in health services research.

What's happening in Innovations in Care Delivery

Innovations in Care Delivery strives to highlight articles that feature advances in care delivery in our Editor's Blog, Editor's Top Five Recommended Reading, and Latest Articles sections. Periodically, we also include interviews with leaders in the field of health services research.