Improving Health Services

Improving Health Services

Background, Method and Applications

Walter Holland

This insightful book describes how Health Services Research (HSR) can be developed and used to evaluate, advance and improve all aspects of health services. It demonstrates the need for good HSR to avoid the continuation or development of ineffective or cost-inefficient services.

Chapter 5: Organisational and funding issues

Walter Holland

Subjects: economics and finance, health policy and economics, politics and public policy, public policy, social policy and sociology, health policy and economics


HSR, in contrast to much laboratory research, is usually complex, takes a considerable amount of time to plan and to carry out, and requires a great deal of competent organisation to ensure the involvement and commitment of those responsible for implementing any findings. For such research to be successful, therefore, it needs to have a stable, long-term base. The cooperation of several disciplines in its design and execution is also essential. In theory, multidisciplinary working is an attractive concept; in practice it presents many difficulties and requires individuals of the highest ability and motivation. And there are few, if any, specific training courses available, despite the fact that methods in research techniques are now taught at Masters level. Multidisciplinarity HSR involves medically qualified individuals, statisticians, social scientists – such as sociologists, psychologists and economists – and will sometimes also require the expertise of management science and operational research. The research unit on Social Medicine and Health Services Research at St Thomas’ Hospital Medical School, which was set up in 1967, was one of the first multidisciplinary units to be established in the UK and has provided a model for subsequent multidisciplinary working. A central problem in this area of work is that of academic commitment and advancement. Individuals who wish to pursue an academic career are recognised by their contribution to their parent subject. Social scientists undertaking HSR in a multidisciplinary unit, for example, require recognition as credible sociologists or psychologists within their own discipline.

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