Introduction to Health Services Research MSOP1016 Research Methods

Research, Audit, and Service Evaluation

• Research seeks generalizable results to address a knowledge gap.
• Audit compares data against predefined standards and/or guidelines (e.g., NICE, CQC).
• Service evaluation aims to demonstrate the merit or worth of a specific service to aid decision-making.
• All three may employ one or more research methods – qualitative, quantitative, or both.

Service Evaluation

• Aims to demonstrate whether new or existing services are feasible, effective, efficient, equitable, or acceptable to service users.
• Questions addressed in a service evaluation include:
  • What works or does not work?
  • Has the desired change or effect been achieved?
  • What patient outcomes have improved as a result of the new service?
  • What is the experience of service users?
  • Does the service meet the needs of the population?
  • Is the service cost-effective or affordable?

Methods Used in Service Evaluation

• May involve multiple study designs – qualitative, quantitative, or both.
• Surveys/questionnaires are commonly used to gather views of service users (e.g., patients, HCPs).
• Feasibility study: a small-scale study that aims to assess specific features of a service in a few selected settings (e.g., to assess acceptability to patients).

Example of Service Evaluation

• Aim: To evaluate the effectiveness of a new stop smoking service in a community pharmacy.
• Objectives:
  • Determine patient/public opinion of the stop smoking service.
  • Determine the number of people who have stopped smoking.
  • Identify the costs of delivering the stop smoking service.

Outcomes in Service Evaluation

• A combination of factors can help provide a holistic picture of the service.
• Examples of outcomes:
  • Patient experience outcomes: e.g., patient satisfaction.
  • Process outcomes: e.g., waiting time, time to implement the intervention.
  • Clinical outcomes: e.g., % adherence, number and nature of minor ailments managed.
  • Cost-related outcomes: e.g., direct costs, cost savings.

Determining Effectiveness

• Methods for determining effectiveness:
  • Before and after comparisons: collect baseline data before the service or intervention, and then compare with data after the service.
  • Control group comparison: compare outcomes of those using the service with those of people not using the service.
  • Compare results with national benchmarks (e.g., data from NHS Digital, ONS).

Health Services Research

• Aims to promote safe and effective medicines use to achieve better patient outcomes.
• Examines how people access and use healthcare, and the impact on patients' health and wellbeing (outcomes).
• Pharmacy practice research is a branch of HSR, considering wider healthcare provision and using similar approaches/methods.

Research Methods

• Quantitative methods:
  • Involve counting, measuring, and quantifying phenomena.
  • Aim to test a specific, pre-defined hypothesis.
  • Statistics are used to analyze data and draw conclusions.
  • May evaluate frequencies of events, proportions of people with certain views, or differences between variables.
• Qualitative methods:
  • Aim to understand people's experiences about a particular phenomenon.
  • Generate hypotheses or clues and explanations about events or phenomena.
  • Use an inductive approach, identifying themes, patterns, or main issues that emerge from the data.
  • Validity lies in the 'trustworthiness', 'richness', and 'depth' of qualitative data.

Introduction to Health Services Research

• Aims to:
  • Create or refine knowledge to explain observed phenomena.
  • Develop new theories.
  • Find better ways of providing patient care.
  • Solve day-to-day problems.

Why Health Services Research?

• To identify the needs of populations and gaps in existing services.
• To contribute to the development of new medicines and use research evidence to inform clinical decisions.
• To show policy makers pharmacy's contribution to healthcare.