Health services research in surgery--definitions, approaches and methods.
OBJECTIVE
Health services research (HSR) investigates the translation of clinical studies into the practice of health care in relation to quality and efficiency from the individual and socioeconomic perspective. Given the fact that HSR has become increasingly popular during the last decade, this article aims at providing an overview of the significance and benefit of HSR in general and especially in the field of surgery.


RESULTS
The first part of the overview provides various definitions that apply to the field, gives a brief historical overview of the development in Germany in contrast to the USA and Great Britain, and describes relevant theoretical frameworks and methods. In the second part it deals with gaps in patient care, patient-related outcomes, registry research, the integration of clinical and ambulatory surgery, and research on implementation of guidelines into practice.


CONCLUSIONS
This overview shows that HSR is by now regarded as an essential field, at least in developed countries, and that we are just at the beginning to understand why demonstrated effective strategies in the clinical context do not or rarely translate into routine patient's care.
Center for Health Services Research Cologne, ZVFK, Cologne, Germany.
O
O
Ommen
C
C
Janssen
H
H
Pfaff
R
R
Lefering
E
E
Neugebauer
D000556:Ambulatory Surgical Procedures / Q000592:standards; D004526:Efficiency; D019317:Evidence-Based Medicine / Q000592:standards; D005858:Germany; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000592:standards; D013514:Surgical Procedures, Operative / Q000592:standards*