Primary Areas of Study for Health Services Research Degrees
To complement the interdisciplinary focus of the Health Services Research MSc or PhD concentration, students will receive advanced training in one of the following areas of study —
Health Services Organization and Management
Faculty Lead: Whitney Berta
The Health Services Organization and Management area of study draws upon the disciplines of organization and management science, implementation science, sociology and organizational psychology to understand the organization of health services and the impact of management and organizational practices on performance.
Students involved in this area of study come with a variety of backgrounds ranging from the basic sciences to the social sciences; all are interested in training for a career in health services research and in leading future research initiatives that include examining meso- and macro-level organization issues, system-level structure and performance, and the uptake and application of research evidence in practice and decision making at all levels of the health care system. Topics of particular interest include: patient safety and quality of care, organizational learning and knowledge transfer, organizational change, leadership, inter-organizational relationships and networks, governance, evidence based management, and evidence based practice change.
Successful completion of this area of study requires demonstrated knowledge of: dominant theoretic frameworks applied to the study of health services organization and management; quantitative, qualitative and mixed methods; research design; and strategies used in primary and secondary data analysis.
In undertaking their dissertation research, students are expected to employ an appropriate theoretical and conceptual framework to guide their dissertation work, and to make both theoretic and practical contributions through their dissertation research.
Faculty Lead: Fiona Miller
Health Policy as an area of study investigates: the political, social and economic conditions that produce and distribute health across populations; examines the systems devoted to sustaining public health or governing, regulating and delivering health care and related social services; and explores the processes through which health and related policies are generated, implemented and achieve their effects, as well as the outcomes of such policies. Students gain knowledge of specific health systems and the challenges they face, as well as analytic approaches to making sense of these arrangements and dynamics.
Studies in Health Policy are commonly of two types. Research “in and for” the policy process seeks to aid in the development, evaluation or implementation of sound policy. Research “of” the policy process asks why policies and systems are as they are, how problems are understood, how authority is exercised and how and why systems change or fail to change. Accordingly, we often engage local, regional and national governmental and non-governmental organizations and decision-makers as partners and collaborators in education, research and knowledge transfer, and consult and participate in policy initiatives and policy-making bodies.
Health policy is an interdisciplinary field. Students typically have backgrounds in one of the social sciences (e.g., political science, sociology, economics, anthropology, history) or applied interdisciplinary areas of study (e.g., policy studies, health studies, public administration, gerontology, social work, etc.), or have developed health policy knowledge from professional experience (e.g., in government, health administration, clinical practice, health law).
Health Services Outcomes and Evaluation
Faculty Leads: Lusine Abrahamyan & Jan Barnsley
The Outcomes and Evaluation area of study draws upon several academic disciplines including economics, epidemiology, and program evaluation to systematically examine the impacts of health services (e.g., mental health, primary care, acute care, chronic care, mental health) on the health status of various populations. Successful completion of this area of study requires demonstrated knowledge of: quantitative, qualitative and mixed methods; primary data collection and secondary data sources; and the strengths, weaknesses and appropriate application of different research designs and data analysis strategies. Students will be exposed to a variety of theoretical and conceptual frameworks and are expected to select and/or adapt such a framework as part of the dissertation. Topics of particular interest include: access to care, health services costs and economic evaluation, performance measurement, and quality improvement.
Health Informatics Research
Faculty Lead: Emily Seto
This primary area of study will nurture a new generation of graduate students to become researchers, clinicians, managers and policy makers who are proficient in their discipline and also in healthcare information management. It will also act as a catalyst for interdisciplinary collaborative research to tackle major issues around the design, development, evaluation and use of electronic health solutions.
Faculty Lead: Audrey Laporte
Health Economics is concerned with the study of resource allocation within the health sector and between that sector and other sectors. The Health Economics area of study is designed to enable participants to apply the foundations of economic analysis to theoretical, empirical, evaluative, and policy issues in the field of health and health care. Specific attention is paid to the choices and other behaviours of health care recipients, health care providers, and third party payers and regulators as well as methods for evaluating health care services, technologies and programs. Graduates will acquire knowledge and skills in the application of theories, concepts and methods to important contemporary issues.
There are a number of generic competencies in Health Economics including knowledge of theories and concepts in health economics and the ability to use and apply it to frame and address health policy problems; knowledge relating to the application of mathematical and statistical techniques to understand and assess the impact of underlying change, including policy shifts, on human and organizational behaviours; conversance with the collection and use of primary and secondary health and economic data obtained from various sources and methods; and the ability to effectively communicate research motivations, study designs, findings and implications for various audiences including academics and decision makers.
Specific Health Economics competencies include knowledge regarding how to develop and apply economic theory and methods in order to:
- Understand approaches taken to the study of the health and health services marketplaces;
- Understand theories and empirical studies of health related behaviours including the demand for health and health services as well as potentially deleterious behaviours such as smoking;
- Understand theories and empirical studies concerning the supply of health services and their application to hospitals, health care professionals and other settings and providers;
- Understand how health care markets work (e.g., those for labour, health services and insurance) including knowledge of the potential sources of market failures, roles for regulatory agencies, informational asymmetry and empirical studies;
- Undertake health service, health technology, and health program appraisals; and appropriately acquire data and apply empirical techniques to identify causal effects.
Health Technology Assessment
Faculty Leads: Beate Sander & Wendy Ungar
According to the Health Technology Assessment (HTA) handbook, HTA is a research based, applied assessment of relevant available scientific evidence and patient perspectives, applied to technology related to health and disease (Danish Institute for HTA, 2001). HTA is related to research due to its methods, but is also related to planning, administration, and management due to its focus on decision-making. HTA can thus be seen as a bridge between a science paradigm and a policy paradigm (Battista & Hodge 1995). Applied HTA takes as its starting point the needs of decision-makers (and their policy advisers) for an evidence informed process for deciding whether or not to adopt and fund health technology and to what extent.
The problem could be the introduction of an innovation, which needs to be studied in relation to other already presently applied technologies in the area (e.g. a novel pharmaceutical product for triskaidekaphobia or an innovative electrophotomicrographical treatment alternative for pneumonoultramicroscopicsilicovolcanokoniosis). Or the problem could be that there are uncertainties about the basis of the use of commonly applied technologies in connection with a certain clinical problem (e.g., diagnostics and treatment of low back pain).
IHPME currently divides the HTA primary area of study (PAS) into two distinct streams: 1) Quantitative Methods and 2) Policy Decision. This separation allows students to delve into the details and nuances of a particular HTA PAS stream while appreciating the need for the information produced in the other stream. The Quantitative Methods Stream focuses on Markov Models, Net Benefit Regression and other techniques for economic evaluation. The Policy Decision Stream focuses on health policy issues related to resource allocation. Students choosing to specialize in Quantitative Methods may be training for a career making models that produce economic evidence. Students choosing to specialize in Policy Decision may be training for a career using economic evidence (along with other forms of evidence) to inform healthcare policy.
Secondary Area of Study
Faculty Lead: Whitney Berta
Students may choose Knowledge Translation as a secondary area of study. This area of study focuses on developing knowledge and research skills that will contribute to the effective and timely incorporation of evidence-based information into the practice of health professionals in such a way as to effect optimal health care outcomes and maximize the potential of the health system. Students who complete the course requirements will acquire a firm understanding of the elements of knowledge translation and be prepared to undertake a research career in this burgeoning and critical area. Students may come from a variety of backgrounds and may include clinicians, clinician-scientists, health services researchers, policy analysts and policy makers.