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 6: Health services research in practice

Walter Holland

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


In its early years, the Department of Health had begun to become interested in planning new health services as well as altering old ones. In practice, planning can either be based on intuition, prior experience and knowledge or on the development of models which can be used to predict likely outcomes. The setting of priorities, for any activity, is difficult. It can be based on beliefs or better on actual evidence – but their acceptance may be problematic if they differ from the hopes and beliefs of those responsible for their implementation. If the full promise of this kind of research is to be realised, then it has to tackle difficult problems and the clear goal at this time was to develop a model that would enable the Department to plan for the total need of care as well as for individual aspects and to carry out effective evaluation. Although important advances were being made in the studies of need, the holistic planning for health services remained a very complex problem although it was the ultimate objective. This type of planning development was advocated particularly by the Department’s Operational Research Branch which was staffed by highly competent researchers with experience in operational research from the Second World War. Operational research had been extremely influential and successful in the planning of services for local government.

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