Schneider Institute for Health Policy,The Heller School for Social Policy and Management,Brandeis University

Components of health services research projects

August 18, 2004

Jose Suaya, MD, MBA, MPH

Funder/project name etc info.

Source

• Designing and conducting health system research projects

• Corlien Varkevisser

• IDRC (Canada) & WHO

Background

• Part of the health system: set of cultural beliefs about health and illness that provide the basis for health seeking and health promoting behavior

Health system

• 1-     The individual, family and community

• 2-     The health care services: public and private sector

• 3-     Health-related sectors

Health services research

• It is problem oriented:

• Concentrate on those factors that help to explain/solve a problem under examination

Types of problems/concerns

• Policy: Role of government/MOH

• Administration and management: monitoring and evaluation procedures

• Direct services: access, acceptability, appropriateness, coverage, quality, cost, effectiveness

• Individual: social/psychological/physical needs ; families

Stages

• I- Statement of the problem• II- Objectives of the study• III- Methodology• IV- Pilot study• V- Work plan• VI- Administration• VII- Monitoring• VIII- Budget Justification• IX- Deliverables

Stage I: Statement of the problem

• Identification of the problem for research

• Analysis of the problem

• Formulation of the statement of the problem

Stage II: Objectives of the study

• Literature Review

• Objectives:• General• Specific

• Title of the study

Stage III: Methodology -a

• Selection, definition, and operationalization of the variables

• Outcome of interest• Exposure or intervention• Confounders

Stage III: Methodology -bStudy design

• Non-interventional studies (observational)• Exploratory• Cross sectional• Follow-up (cohort)• Case control

• Interventional studies• Experiment• Quasi-experiment

Goal of the study

• To obtain:

• Valid: true conclusions

• Reliable: same method, same circumstances, same results

Threats to validity

• Confounders

• History

• Differential loss

• Hawthorne effect

Stage III: Methodology -c

Data collection techniques

• Use of available data• Observation: watching and recording

behavior• Interviews• Written questionnaires• Focus groups discussions• Combination of the above

Stage III: Methodology -dSampling

• Non Probabilistic• Convenience• Quota

• Probabilistic• Simple random sample• Systematic• Cluster sampling• Multistage

Stage III: Methodology -e

Sample Size

• Desirable• Expected value (expected proportion)• Margin error for the estimate • Precision (e.g. 95%)

• Feasible• Cases, human, time, money

Stage III: Methodology -f

Data Collection and Data Handling

• What• How• By whom• When• Sequence• Quality control

Stage III: Methodology -g

Data Compilation

• Software• Data base development• Coding• Data entry• Verification and Validation• Programming

Stage III: Methodology -h

Data Analysis

• Plan for data analysis• Univariate• Bivariate• Multivariate• Graphical representation

Stage IV: Pilot Study

• Helps to identify potential problems in methodology and logistics

Stage V: Workplan

• Workload: tasks, duration, and person responsible for each of the activities

• Time schedule (Gantt): describe graphically the order and the duration for each of the activities

Stage VI: Administration

• Human • Material• Financial• Logistical resources

• Accountability

Stage VII: Monitoring

• Ongoing process of checking implementation of the project:

• Track of resources used• Number and quality of tasks completed

Stage VIII: Budget Justification

• Starting from the working plan, identify the resources needed for each activity and calculate the unit cost and total cost

Stage IX: Deliverables

• Progress Reports• Scientific• Financial

• Final Report/ Publishable Papers