title: Health services and policy research in hepatology.
abstract: OBJECTIVE
  This article examines recent health services and policy research studies in hepatology and liver transplantation.
  
  
  RESULTS
  Critical issues include access to medical care, timeliness of referral and consultation, resource utilization in clinical practice, comparative effectiveness research, and the evaluation of care delivery models. Despite policymaking efforts, there continues to be unwarranted variation in access to subspecialty care and liver transplantation services based on race and geographic location. Variations in primary care and specialist awareness of practice guidelines for liver disease contribute to disparities in appropriateness and timeliness of treatments. Defining the cost-effectiveness of increased resource utilization for novel antiviral therapies and liver transplantation continues to stimulate controversy. Few comparative effectiveness studies in hepatology exist to date, yet a growing number of analyses using national datasets will help inform policy in this arena. Identifying care delivery models that demonstrate high value for populations with chronic liver disease is critical in the context of recent healthcare reform efforts.
  
  
  CONCLUSIONS
  Health services and policy research is a growing field of investigation in hepatology and liver transplantation. Further emphasis on research training and workforce development in this area will be critical for understanding and improving patient-centered outcomes for this population.
authors.affiliation: aMayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery bDivision of Gastroenterology and Hepatology cWilliam J. von Liebig Transplant Center, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jayant A
authors.initials: JA
authors.lastname: Talwalkar
mesh_terms: D003695:Delivery of Health Care; D005762:Gastroenterology / Q000458:organization & administration*; D006291:Health Policy; D006295:Health Resources / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation; D012017:Referral and Consultation / Q000706:statistics & numerical data