What is Health Services Research?
Health services research in VA examines the organization, delivery, and financing of health care, from the perspectives of patients, caregivers, providers, and managers to improve the quality and economy of care. Specifically, HSR&D is interested in evaluations of the structure, processes, and outcomes of care, including issues of patient safety and equity. HSR&D also is concerned with system-level outcomes such as assessments of cost and access, as well as effective ways to translate clinical knowledge into practice. The underlying objective of health services research in VA is to understand and improve clinical decision-making and care, inform patients, evaluate changes in the health care system, and inform VA policymaking.
HSR&D projects are often multidisciplinary activities. They involve expertise in a combination of clinical fields (medicine and all its specialties, nursing, and other health care professions), social sciences (especially psychology, sociology, economics, and organization theory), and multiple research approaches and methods (experimental and quasi-experimental studies, survey research, database analyses, biostatistics, psychometrics, econometrics, modeling techniques, etc.). The following topical areas are not exhaustive. Please view HSR&D's studies section for additional examples of HSR&D projects.
Research that fits HSR&D
- Studies that evaluate the effectiveness of clinical procedures or practices and processes of care in the "real world." We define effectiveness as: "How an intervention performs in the complex and variable context of real-world use and practice."
- Studies that compare VA outcomes, cost, and quality of care among VA sites or between VA and non-VA providers
- Evaluation of utilization patterns and costs associated with practice patterns, interventions, implementation efforts, policy changes, and related health services topics
- Research that develops and evaluates new measures and methods for use in health services research. A clarification of our policy on Support for Scientific Research and Development Projects (1204.1) is available here.
- Studies focused on implementing research findings into practice
- Variations in care (e.g., ethnic, cultural, provider, geographic based) and their determinants
- Research on organization, management, and leadership in health care
Research that does not fit HSR&D
- In general, studies involving clinical interventions still regarded as experimental are not in the domain of health services research (efficacy studies); especially studies of experimental drugs, procedures, or devices. We define efficacy as: "How reliably an intervention brings about a given result under ideal, controlled conditions."
- All bench science (wet lab) and animal studies
- Most epidemiology studies where the primary focus is establishing base rates
- Most computer software development efforts unless a relatively small portion of a project