Chapter 12

What are the clear distinctions in methods and findings across different types of healthcare research?

Different types of healthcare research focus on various aspects of healthcare such as individual patients, populations, and health systems.

What is the goal of health services research?

To find new and more effective means of diagnosis and treatment to improve the quality and length of life.

What does biomedical research focus on?

It focuses on organism subindividual level.

What type of research involves clinical trials of diagnostic procedures or new drugs?

Experimental research.

What is health policy and systems research (HPSR)?

An emerging field that seeks to improve how societies organize themselves in achieving collective health goals.

What is the focus of public health research?

It focuses on community or population-level health, including epidemiological studies.

What characterizes observational studies in epidemiological research?

They are studies collecting observed or reported information about natural phenomena and behaviors.

What is the mission of the Agency for Healthcare Research and Quality (AHRQ)?

To improve the outcomes and quality of healthcare services, reduce costs, address patient safety, and broaden effective services.

What type of research tests hypotheses to explain biological phenomena?

Analytic studies.

What was revealed by John Wennberg’s studies regarding hospitalization rates?

The number of surgeons and available hospital beds correlated with the rate of hospitalizations.

What is the importance of systems thinking in health research?

It recognizes that action or changes in one aspect of a health system can affect other outcomes.

What does descriptive research in public health focus on?

It focuses on patient records, interview surveys, and databases to describe health phenomena.

What type of care is involved in the limitation and rehabilitation of disability?

Palliative care for those who are irreversibly ill.

What was one finding from the Framingham Massachusetts study?

There is an association between diet, weight, exercise, and heart disease.

What role does AHRQ play in clinical practice guidelines?

It evaluates recommendations to ensure they are based on systematic literature reviews and revised for currency.

What is the mission of Agency for Healthcare Research and Quality

AHRQ’s mission:
1. Improve the outcomes and quality of healthcare services

2) Reduce their costs;

3) Address patient
safety; &

4) Enhance services by building a strong scientific foundation to improve clinical and health systems practices.

What are the AHRQ initiatives

1. Healthcare Associated Infections

2. Comparative Health Systems performance

3. Treatment of Opioud Abuse in Rural Care settings

4. Patient-centered outcomes Research

5. Evidence Base Reports

Avedis Donabedian

number, kinds, & skills of the providers, & adequacy of their
physical resources and the manner in which they perform procedures, should influence the quality of subsequent outcomes

The Joint Commission on Accreditation of Hospitals

make judgments about the quality of hospitals based on structural standards

Empirical quality standards:

:derived from distributions, averages, ranges, and data
variability. Information collected from similar health service providers is compared to
identify practices that deviate from the norms.
 Patient severity-adjusted hospital performance data
 Performance “report cards”

Evidence Based Medicine

is conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients

What does the practice of using evidence base medicine means

integrating individual clinical expertise with the best available external clinical evidence
from systematic research

Best evidence

highest form of evidence available for a particular medical issue or
question in the hierarchy of evidence derived from research

Hierarchy of evidence

1. Systematic Review
2. Randomized controlled clinical trial
3. Observational study
4. Case series
5. Expert opinion

what is the goal of evidence based medicine

to inform the practice of medicine by
providing practitioners with the ability to determine
the highest level of evidence for their clinical
questions & then use their clinical judgment along
with patients’ preferences and values for its
application

What do research outcome do

Evaluates results of healthcare processes in the real world of physicians’ offices,
hospitals, clinics and homes

Functional status

3 components assessing patients’ abilities to function in their
own environment:

What are the 3 components of Functional status

1. Physical functioning
2. Role functioning: extent to which health interferes with usual daily activities
3. Social functioning: whether health affects normal social activities

Personal wellbeing

Personal well-being: patients’ sense of physical and mental well-being, their
general mood, their personal view of their general health and quality of life

Patient satisfaction

measures patients’ view about the services received,
including access, convenience, communication, financial coverage and
technical quality

appropriateness studies

determine the circumstances in which a procedure
should or should not be performed

Epidemiological Research

Distribution & determinants of health, diseases and injuries in human populations