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 —
Faculty Lead: Peter Coyte
Health Economics deals with how to maximize outcomes such as population health and societal well-being by optimizing the use of scarce resources within the health care sector and between that sector and other sectors, in consideration of the impact of different modes of organization on stakeholder costs as well as equity in the distribution of access to care and health outcomes. It studies the role of incentives, behaviours and system structures in influencing the ability of individual patients, health care professionals and health services institutions such as hospitals to act in ways that maximize social welfare.
Students in this area of study learn about the theories and methods of health economics and how to apply them to evaluate programs as well as frame and address health policy problems. Students will build their capacity in the application of mathematical and statistical techniques to understand and assess the impact of underlying change, including policy shifts, on human and organizational behaviours using primary and secondary health and economic data. The courses emphasize training in the effective communication of research motivations, hypotheses, study designs, findings and implications for various audiences including academics and decision makers. No previous training in economics is assumed.
Some examples of areas of study include:
- Theoretical and empirical studies of the determinants of health as well as health related behviours (e.g. smoking, drug use)
- Theories and empirical studies concerning the supply of and demand for health services including hospital care, services provided by health care professionals as individuals and teams and other care settings
- Research related to how health care markets work (e.g. those for health human resources, health services and insurance) including knowledge of potential sources of market failures, roles for regulatory agencies and informational asymmetry
- Undertake health service, health technology, and health program appraisals to identify causal effects and to consider implications of programs and policies for cost, equity and access within the health care system and for patients and other stakeholder groups
Health Informatics Research
Faculty Lead: Emily Seto
Health Informatics is the intersection of the fields of information technology and healthcare/health. Students come from a variety of different backgrounds, including medicine, engineering, public health and information science. The objective is to nurture a new generation of graduate students to become researchers, clinicians, decision makers and policy makers, who are proficient in their discipline and also in health information management and research. It will also act as a catalyst for interdisciplinary collaborative research to tackle major issues around the design, development, evaluation and implementation of electronic health solutions.
Graduates will gain an understanding of the role digital health currently plays in our health care system, as well as its potential to transform clinical management and consumer health. Students will learn how to engage and incentivize all relevant stakeholders in complex health systems to successfully implement improved health information systems. An emphasis will be placed on equipping students with the necessary research tools, including the use of conceptual frameworks and research methods, for them to investigate their own specific areas of interest.
Faculty Lead: Rob Schwartz
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).
Some examples of areas of study include:
- Comparative health policy and health systems research, to support rigorous comparison of health policies as well as health systems, structures and organization across jurisdictions, to draw valid policy lessons and to suggest policy and system options to the status quo.
- Public health policy research, including studies of policies that address the promotion of wellness and prevention of chronic disease, infectious disease, injury and environmental exposures and systems for governing, regulating and delivering public health strategies and interventions. Public health policy researchers are also interested in healthy public policies that address the effects on population health of policies that emanate from non-health sectors of government.
- Health care policy research, including the study of policy and systems for governing, regulating, financing and delivering health care. The term health care is used broadly, to refer to hospital care, physician services, pharmaceuticals, rehabilitation, long term chronic care, home and community care and/or related social services (e.g. supportive housing) and may interface with aspects of public health policy.
- Health technology policy research, including studies of health research systems, or health technology development, regulation, adoption or diffusion.
Health Services Outcomes and Evaluation
Faculty Leads: Lusine Abrahamyan & Katie Dainty
The Outcomes and Evaluation area of study draws upon several academic disciplines including epidemiology, program evaluation and economics to systematically examine the impacts of health services (e.g., mental health, primary care, acute care, chronic care) 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, evaluation of complex interventions, utilization of health services, economic evaluation, performance measurement, and quality improvement.
Some examples of study topics include:
- An assessment of the implementation of an early stage audit and feedback intervention in primary care
- The association of health literacy and health services utilization
- The doctor-patient relationship and colorectal cancer screening
- The quality of care among older adults with multiple chronic conditions
Health Technology Assessment
Faculty Leads: Beate Sander & Wendy Ungar
HTA is a research based, applied assessment of emerging health technologies using available scientific evidence and patient perspectives. HTA is related to the production of research evidence, but it is also related to planning, administration and management, i.e. consumption of evidence, 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.
The focus of an HTA could be the introduction of an innovation, which needs to be studied in relation to other presently applied technologies, the removal of obsolete technologies, or uncertainty regarding commonly applied technologies.
The HTA primary area of study encompasses quantitative methods as well as policy courses. This diversity allows students to delve into the details and nuances of a particular HTA PAS according to their interests. Quantitative methods include cost-effectiveness analysis, Markov models, meta-analysis, net benefit regression and other techniques for economic evaluation. Policy courses examine health policy issues related to resource allocation. Students slanting their courses in quantitative methods may be training for a career in producing economic evidence. Students choosing to slant their HTA program toward policy may be training for a career using economic evidence (along with other forms of evidence) to inform healthcare policy decision-making.
Organization and Management Studies
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.
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.