Chapter 1: Health services research: a general perspective
Health services research (HSR) differs markedly from the clinical research traditionally associated with medicine. Most clinical research focuses on the investigation of natural diseases occurring in humans. The problems examined are those posed by knowledge of the normal or diseased and examination occurs within the defined boundaries of a particular branch of science such as genetics, molecular biology or immunology. In clinical research, the main area of enquiry relates to the application of this type of scientific biology to the manifestation and treatment of disease in man and is now often referred to as translational research. The term HSR is used variably by different groups and is often misunderstood. It describes a field of enquiry characterised by its applied and multidisciplinary nature and occupies territory that includes public health research, population health sciences, health systems research and clinical research. Definitions have been proposed by various organisations and individuals ranging from the Advisory Committee on Medical Research of the World Health Organisation, Flook and Sanazaro, and the Academy of Medical Science Working Group. All are agreed that HSR is concerned with the relationship between need, demand, supply, use and outcome of health services. The discipline, therefore, examines some or all of the following factors: quality, distribution, access, outcome and effectiveness of health care services, irrespective of who provides them.
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