Components of health services research projects

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• Components of health services research projects
• August 18, 2004

Jose Suaya, MD, MBA, MPH
Funder/project name etc info.
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Source

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

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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

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Health system

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

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Health services research

• It is problem oriented
• Concentrate on those factors that help to
  explain/solve a problem under examination

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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

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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

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Stage I Statement of the problem

• Identification of the problem for research
• Analysis of the problem
• Formulation of the statement of the problem

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Stage II Objectives of the study

• Literature Review
• Objectives
• General
• Specific
• Title of the study

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Stage III Methodology -a

• Selection, definition, and operationalization of
  the variables
• Outcome of interest
• Exposure or intervention
• Confounders

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Stage III Methodology -b

• Study design
• Non-interventional studies (observational)
• Exploratory
• Cross sectional
• Follow-up (cohort)
• Case control
• Interventional studies
• Experiment
• Quasi-experiment

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Goal of the study

• To obtain
• Valid true conclusions
• Reliable same method, same circumstances, same
  results

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Threats to validity

• Confounders
• History
• Differential loss
• Hawthorne effect

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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

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Stage III Methodology -d

• Sampling
• Non Probabilistic
• Convenience
• Quota
• Probabilistic
• Simple random sample
• Systematic
• Cluster sampling
• Multistage

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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

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Stage III Methodology -f

• Data Collection and Data Handling
• What
• How
• By whom
• When
• Sequence
• Quality control

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Stage III Methodology -g

• Data Compilation
• Software
• Data base development
• Coding
• Data entry
• Verification and Validation
• Programming

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Stage III Methodology -h

• Data Analysis
• Plan for data analysis
• Univariate
• Bivariate
• Multivariate
• Graphical representation

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Stage IV Pilot Study

• Helps to identify potential problems in
  methodology and logistics

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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

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Stage VI Administration

• Human
• Material
• Financial
• Logistical resources
• Accountability

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Stage VII Monitoring

• Ongoing process of checking implementation of the
  project
• Track of resources used
• Number and quality of tasks completed

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Stage VIII Budget Justification

• Starting from the working plan, identify the
  resources needed for each activity and calculate
  the unit cost and total cost

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Stage IX Deliverables

• Progress Reports
• Scientific
• Financial
• Final Report/ Publishable Papers