Components of health services
research projects
August 18, 2004
Jose Suaya, MD, MBA, MPH
Schneider Institute for Health Policy,
The Heller School for Social Policy and Management,
Brandeis University
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
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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 -b
Study design
• Non-interventional studies (observational)
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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 -d
Sampling
• Non Probabilistic
• Convenience
• Quota
• Probabilistic
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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
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What
How
By whom
When
Sequence
Quality control
Stage III: Methodology -g
Data Compilation
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Software
Data base development
Coding
Data entry
Verification and Validation
Programming
Stage III: Methodology -h
Data Analysis
• Plan for data analysis
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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
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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