Schneider Institute for Health Policy, The Heller School for Social Policy and Management, Brandeis University Components of health services research projects August 18, 2004 Jose Suaya, MD, MBA, MPH Funder/project name etc info.

Source Designing and conducting health system research projects Corlien Varkevisser IDRC (Canada) & WHO

Background Part of the health system: set of cultural beliefs about health and illness that provide the basis for health seeking and health promoting behavior

Health system 1- The individual, family and community 2- The health care services: public and private sector 3- Health-related sectors

Health services research It is problem oriented: Concentrate on those factors that help to explain/solve a problem under examination

Types of problems/concerns Policy: Role of government/MOH Administration and management: monitoring and evaluation procedures Direct services: access, acceptability, appropriateness, coverage, quality, cost, effectiveness Individual: social/psychological/physical needs ; families

Stages I- Statement of the problem II- Objectives of the study III- Methodology IV- Pilot study V- Work plan VI- Administration VII- Monitoring VIII- Budget Justification IX- Deliverables

Stage I: Statement of the problem Identification of the problem for research Analysis of the problem Formulation of the statement of the problem

Stage II: Objectives of the study Literature Review Objectives: General Specific Title of the study

Stage III: Methodology -a Selection, definition, and operationalization of the variables Outcome of interest Exposure or intervention Confounders

Stage III: Methodology -b Study design Non-interventional studies (observational) Exploratory Cross sectional Follow-up (cohort) Case control Interventional studies Experiment Quasi-experiment

Goal of the study To obtain: Valid: true conclusions Reliable: same method, same circumstances, same results

Threats to validity Confounders History Differential loss Hawthorne effect

Stage III: Methodology -c Data collection techniques Use of available data Observation: watching and recording behavior Interviews Written questionnaires Focus groups discussions Combination of the above

Stage III: Methodology -d Sampling Non Probabilistic Convenience Quota Probabilistic Simple random sample Systematic Cluster sampling Multistage

Stage III: Methodology -e Sample Size Desirable Expected value (expected proportion) Margin error for the estimate Precision (e.g. 95%) Feasible Cases, human, time, money

Stage III: Methodology -f Data Collection and Data Handling What How By whom When Sequence Quality control

Stage III: Methodology -g Data Compilation Software Data base development Coding Data entry Verification and Validation Programming

Stage III: Methodology -h Data Analysis Plan for data analysis Univariate Bivariate Multivariate Graphical representation

Stage IV: Pilot Study Helps to identify potential problems in methodology and logistics

Stage V: Workplan Workload: tasks, duration, and person responsible for each of the activities Time schedule (Gantt): describe graphically the order and the duration for each of the activities

Stage VI: Administration Human Material Financial Logistical resources Accountability

Stage VII: Monitoring Ongoing process of checking implementation of the project: Track of resources used Number and quality of tasks completed

Stage VIII: Budget Justification Starting from the working plan, identify the resources needed for each activity and calculate the unit cost and total cost

Stage IX: Deliverables Progress Reports Scientific Financial Final Report/ Publishable Papers