with an associated consideration of their costs, staffing, and relationship to the health services provided, will be increasingly critical as personal health care services are restructured with a focus on cost containment and as hard decisions are made about the investment of both public and private resources.

Provider and Consumer Behavior

Health services research can describe how providers act and examine why they make the clinical, ethical, and financial decisions they do. The influence of education, training, and underlying socialization processes on these behaviors is only dimly understood. We do not know how providers make decisions or how they work together; neither do we fully grasp how the growing availability of practice guidelines affects clinicians. Similar attention can be paid to exploring how clinicians choose specialties and practice locations.

Health services research can explore further the behavior of the four audiences for its products identified by AHCPR: consumers, policymakers, managers, and providers. By investigating the financial implications of behavior and, conversely, the behavioral implications of different financial circumstances among consumers, providers, and payers, health services researchers can learn how financial incentives and organizational structures influence performance and behavior at all levels.

While pursuing the supply side of health care (whether measuring its product as health status or as units of service), health services research can also work toward a general theory of demand for health care. Furthermore, in the United States, having health insurance is not sufficient to ensure that an individual will receive timely and appropriate care. Health services research can explore significant demand-related questions about nonfinancial barriers to care, such as what might cause nonusers of health services to seek appropriate preventive or curative services.

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