title: [Advantages and disadvantages of incorporating qualitative methodology in the evaluation of health services. A practical case: evaluation of a high-resolution clinic].
abstract: OBJECTIVE
  We examined the usefulness of incorporating a qualitative phase in the evaluation of the quality of care in a high-resolution medical service carried out with quantitative methods.
  
  
  METHODS
  A quantitative research was performed using a structured questionnaire and selecting interviewees by systematic randomized sampling methods (n=320). In addition, a qualitative research was carried on through semi-structured interviews with patients selected by convenience criteria (n=11), observations in the care assistance circuit, and a group interview with health professionals working in the service. A multidisciplinary research team conducted an individual analysis of the information collected in both quantitative and qualitative phases. Subsequently, three meetings based on group brainstorming techniques were held to identify the diverse contributions of each of the methodologies employed to the research, using affinity graphs to analyse the different results obtained in both phases and evaluate possible bias arising from the use of qualitative methods.
  
  
  RESULTS
  Qualitative research allowed examining specific aspects of the health care service that had been collected in the quantitative phase, harmonizing the results obtained in the previous phase, giving in-depth data on the reasons for patient dissatisfaction with specific aspects, such as waiting times and available infrastructures, and identifying emerging issues of the service which had not been previously assessed.
  
  
  CONCLUSIONS
  Overall, the qualitative phase enriched the results of the research. It is appropriate and recommendable to incorporate this methodological approach in research aimed at evaluating the quality of the service in specific health care settings, since it is provided first hand, by the voice of the customer.
authors.affiliation: Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Madrid. dalvarez@isciii.es
authors.forename: D
authors.initials: D
authors.lastname: Alvarez Del Arco
authors.forename: C
authors.initials: C
authors.lastname: Rodríguez Rieiro
authors.forename: C
authors.initials: C
authors.lastname: Sanchidrián De Blás
authors.forename: B
authors.initials: B
authors.lastname: Alejos
authors.forename: R
authors.initials: R
authors.lastname: Plá Mestre
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology; D009790:Occupations; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration / Q000592:standards*; D010045:Outpatients / Q000523:psychology; D017060:Patient Satisfaction; D015397:Program Evaluation; D036301:Qualitative Research; D011787:Quality of Health Care; D012494:Sampling Studies; D013030:Spain; D011795:Surveys and Questionnaires