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The volume of cancer-related health services research articles appears to have been relatively stable during the 1980s, but increased sharply in the 1990s according to Medline searches from 1980 to 1997. In 1997, there were more than 1,200 articles indexed that addressed health services research issues related to cancer (Figure 7.1). Although the number of health services research citations increased during this period, by 1997 they represented less than 3 percent of all cancer-related citations indexed in the medical literature (Figure 7.2). These trends reflect publications in English, but not necessarily articles written by U.S. investigators. Much of the literature reviewed in Chapter 5 was conducted in the United Kingdom and is represented here. Figures 7.1 and 7.2 therefore reflect trends in the general medical literature, not necessarily trends in the United States. These trends must be interpreted with caution because they may reflect changes in the way MESH headings are applied to index the literature rather than real increases in cancer-related health services research.
BOX 7.2Topics in Health Services Research
Health services research may address, or be conducted for the purposes of understanding or improving, areas such as the following:
need and demand for health care;
availability and accessibility of health care;
utilization of health care;
patient preferences (e.g., for treatments, providers, settings);
patient compliance with treatment;
organization and delivery of health care (e.g., managed care versus fee for service);
health care workforce;
financing of health care (e.g., public and private third-party payment, capitation);
costs, cost-effectiveness, cost-benefit, and other economic aspects of health care;
patient and population health status or quality of life;
outcomes of health care technologies and interventions;
practice patterns and diffusion of technologies or interventions;
quality assurance programs and techniques;
guidelines, standards, and criteria for health care;
health care administration and management;
health education and patient instruction;
health professions education;
health planning and forecasting;
legal and regulatory changes affecting the health care system (e.g., antitrust laws);
data and information needed for health care decision making (e.g., report cards); and
clinical trials (including randomized controlled trials) of the effectiveness of health care technologies or interventions.