Brook R H
Division of Geriatrics, University of California, Los Angeles Center for the Health Sciences.
Acad Med. 1989 Mar;64(3):124-30. doi: 10.1097/00001888-198903000-00004.
Two principles shape an applied research field such as health services research. First, studies can be classified as methodological, descriptive, analytical, or experimental; and second, health services research is conducted at two levels, the doctor-patient level and the policy level. Twenty years of increasingly sophisticated description and analysis allow researchers now to measure better the appropriateness and outcome of care, both at the policy level (do cuts in medical coverage affect patients' health?) and at the individual level (does physicians' behavior affect patient compliance and thereby outcome?). Further, researchers have been able to develop increasingly useful measures of patient health status and function. Consequently, relations between the public and physicians and medical institutions will change further as patients receive more and better information about hospital mortality rates, quality-of-life measures, and similar results of health services research. Conducting good health services research is complicated, depends upon teams of physicians and social scientists working together, and produces complex, not simple, results, but it is worth the effort because the results make a difference to physicians and to the American people.
两个原则塑造了诸如卫生服务研究这样的应用研究领域。其一，研究可分为方法学研究、描述性研究、分析性研究或实验性研究；其二，卫生服务研究在两个层面开展，即医患层面和政策层面。二十年日益精细的描述与分析使研究人员如今能够在政策层面（医保覆盖范围的削减是否会影响患者健康？）和个体层面（医生的行为是否会影响患者的依从性进而影响治疗结果？）更好地衡量医疗服务的适宜性和结果。此外，研究人员已经能够开发出越来越有用的患者健康状况和功能衡量指标。因此，随着患者获得更多关于医院死亡率、生活质量指标以及卫生服务研究类似结果的更好信息，公众与医生及医疗机构之间的关系将进一步改变。开展良好的卫生服务研究很复杂，依赖于医生和社会科学家团队的共同协作，并且会产生复杂而非简单的结果，但这一努力是值得的，因为研究结果对医生和美国民众都有重要意义。
