Population & health services research. Editorial.
“This is an exciting time for pediatric urology research.” This is how Dr. Jonathan C. Routh put it in the proposal for a section of health services research (HSR) that he and several others (including myself), submitted to the editors of the Journal of Pediatric Urology last year. By this, he meant that increasing numbers of clinician-scientists are performing new types of research, which are pushing the boundaries of our field. These new research methods allow us to examine areas that have been heretofore unknown or unexamined, which in turn will allow us to improve the quality of the care that we provide to our young patients. I have been given the distinct honor of serving as the first assistant editor in charge of this new section, which has been designated as the Section of Population and Health Services Research. What is HSR? This term means many things to many people. The Agency for Healthcare Research and Quality’s definition states that “Health services research examines how people get access to health care, how much care costs, and what happens to patients as a result of this care. The main goals of health services research are to identify the most effective ways to organize, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety.” The “bumper sticker” version is that HSR seeks to ensure that the right patient gets the right care, at the right time and place, in the right way, in a cost-effective and safe manner, every time. As clinicians, this is obviously a goal that we all share and seek to accomplish every day in our professional lives. As researchers, these definitions provide a framework to guide the questions we ask, and how we seek to answer them. What kinds of research qualify as HSR? While the boundaries are hazy, some of the investigational methods that health services researchers may employ include patient-reported outcomes assessment (and development of tools to facilitate this), cost-effectiveness studies and decision analysis, systematic reviews and meta-analysis, research into healthcare financing and its impact on care access and quality, comparative effectiveness research, quality improvement, medical error prevention and patient safety, research on socioeconomic disparities in access to