Health services and systems research in Europe: overview of the literature 1995-2005.
BACKGROUND
Our objective, within the collaborative study SPHERE (Strengthening Public Health Research in Europe) is to give an overview of health services and health systems research in Europe, based on a search of the literature in PubMed and Embase.


METHODS
The method used in this study consisted of: (i) A bibliometric analysis, and (ii) Classification of health services and systems research according to pre-defined criteria for a sample of 500 publications in the PubMed search.


RESULTS
Health services research is particularly strong in the Nordic countries. The number of publications on health services research has increased steadily between 1996 and 2004, 60% of the references found had a keyword related to 'patient'. More than one-third of the references had a keyword related to 'hospital'. The keyword 'general practitioner' occurred in 16% of the cases. The emphasis on this keyword was higher in those countries where the GP traditionally holds a strong position, but also in the new member states, Estonia and Slovenia. Of a smaller sample classified in depth; 57% addressed problems of efficiency and quality improvement; 27% focused on the organization of health care, cohesion and arrangement of supply according to needs and demands; only 10% addressed problems of inequalities and distribution of services.


CONCLUSIONS
Health services research is a growing domain of research. As an applied discipline, health services research can be expected to closely follow political agendas. The majority of studies focus on improving the efficiency and quality of the system. Only 10% of the studies address inequalities in health utilization.
Delnoij
Diana M J
DM
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. d.delnoij@nivel.nl
Groenewegen
Peter P
PP
D015706:Bibliometrics; D003695:Delivery of Health Care; D005060:Europe; D006296:Health Services; D012196:Review Literature as Topic