Health Services Research Work Force and Educational Issues (1995) / Chapter Skim
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Pages 1-12
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Furthermore, just as health services research has helped decisionmakers understand and shape the health care system of the past, so too can it continue to inform critical decisions by government officials, corporate leaders, clinicians, health plan managers, and even ordinary people making choices about health problems ranging from minor to catastrophic.
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ORIGINS OF THE STUDY This report focuses on one part of the field of health services research-its work force and its programs for educating and training that work force. The study originated in a request from the Agency for Health Care Policy and Research (AHCPR)
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DEFINING HEALTH SERVICES RESEARCH After reviewing various definitions of health services research, the committee formulated the following definition: Health services research is a multidisciplinary field of inquiry, both basic and applied, that examines the use, costs, quality, accessibility, delivery, organization, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.
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Thus, the boundaries of health services research, health care management, and health policy are not sharp. Finally, this definition does not explicitly restrict research to personal health services.
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Using its multiple databases, the committee identified approximately 5,000 current health services researchers. As an estimate of the size of the work force, this number omits some health services researchers and includes some individuals
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On qualitative grounds, however, the committee foresees expansion in the health services research work force if public research funding escapes significant reductions and if organizations competing in the emerging health care market continue to support growth in knowledge about the quality, effectiveness, and cost of clinical services, the behavioral determinants of health status, and similar questions. The committee also was not able to make an empirically based, quantitative statement about the match between current supply and current demand for health services researchers.
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Health services research education and training are provided under many different organizational auspices, for example, as part of doctoral programs in health policy and administration, public health, nursing, social work, biostatistics, and economics. The committee noted, however, that formal programs in health services research play a special role by providing an organizing focus for the field and an environment supportive of creative research and methodology development.
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In particular, the committee recommended that AHCPR consider greater emphasis for some predoctoral and postdoctoral awards for training in areas such as outcomes/health status measurement, biostatistics, epidemiology, health economics, and health policy in which recruiting difficulties have been reported; · more explicitly consider in evaluating institutional training program awards-how institutions' approaches to training, faculty composition, research opportunities, and training slots relate to high-demand areas; and set aside a substantial percentage of institutional awards for innovative programs in health services research, which could be completely new programs or significant modifications of existing programs (see below)
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Among the critical areas for continued attention are the following: Organization andfinancing of health services. Health services research can inform the debate over incremental reforms in health insurance and market-based strategies to control health care costs.
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This report has examined a critical component of the health services research enterprise its work force and its programs for educating and training that work force. The conclusions reflect the committee's judgment that this work force plays an important role in providing information and tools that are necessary for an effectively functioning health care market and an accountable health care system.
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Like research and education in the biomedical and clinical sciences, generally, health services research and research training are public goods worthy of support by society as a whole.
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