title: Methods in public health services and systems research: a systematic review.
abstract: BACKGROUND
  Public Health Services and Systems Research (PHSSR) is concerned with evaluating the organization, financing, and delivery of public health services and their impact on public health. The strength of the current PHSSR evidence is somewhat dependent on the methods used to examine the field. Methods used in PHSSR articles, reports, and other documents were reviewed to assess their methodologic strengths and challenges in light of PHSSR goals.
  
  
  METHODS
  A total of 364 documents from the PHSSR library met the inclusion criteria as empirical and based in the U.S. After additional exclusions, 327 of these were analyzed.
  
  
  RESULTS
  A detailed codebook was used to classify articles in terms of (1) study design; (2) sampling; (3) instrumentation; (4) data collection; (5) data analysis; and (6) study validity. Inter-coder reliability was assessed for the codebook; once it was found reliable, the available empirical documents were coded.
  
  
  CONCLUSIONS
  Although there has been a dramatic increase in the amount of published PHSSR recently, methods used remain primarily cross-sectional and descriptive. Moreover, although appropriate for exploratory and foundational work in a new field, these approaches are limiting progress toward some PHSSR goals. Recommendations are given to advance and strengthen the methods used in PHSSR to better meet the goals and challenges facing the field.
authors.affiliation: George Warren Brown School of Social Work, Washington University in St Louis, St Louis, Missouri 63130, USA. jharris@brownschool.wustl.edu
authors.forename: Jenine K
authors.initials: JK
authors.lastname: Harris
authors.forename: Kate E
authors.initials: KE
authors.lastname: Beatty
authors.forename: Colleen
authors.initials: C
authors.lastname: Barbero
authors.forename: Alex F
authors.initials: AF
authors.lastname: Howard
authors.forename: Robin A
authors.initials: RA
authors.lastname: Cheskin
authors.forename: Robert M
authors.initials: RM
authors.lastname: Shapiro
authors.forename: Glen P
authors.initials: GP
authors.lastname: Mays
mesh_terms: D006302:Health Services Research / Q000379:methods*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011634:Public Health / Q000191:economics / Q000592:standards* / Q000639:trends; D011635:Public Health Administration; D012107:Research Design; D013597:Systems Analysis; D014481:United States