Health Services Research and Managerial Epidemiology

Our new journal, Health Services Research and Managerial Epidemiology, links 2 important and related fields of study. Health services research (HSR) is the study of cost, quality, and access in health care. Or, you could say it is the study of efficiency, effectiveness, and accessibility. Either way, HSR is a multidisciplinary field drawing from economics, clinical medicine, psychology, sociology, health care management, and epidemiology. Health services research is important both for medical management and for health policy. Its development has been fostered by a series of federal agencies, including most recently the Agency for Healthcare Research and Quality. Health services research studies typically rely on analysis of large claims databases, large population surveys, or electronic medical records.

Managerial epidemiology (ME) is the application of epidemiologic methods to management problems.¹ The medical record is a typical source of data. Clinical measures are usually included as independent or dependent variables, including diagnoses, procedures, and test results. Designs for these studies might be retrospective cohorts, case–control, cross-sectional, or quasi-experiments. Managerial epidemiology differs from clinical epidemiology in its preference for observational designs applied to archival data as opposed to randomized experiments. Managerial epidemiology addresses concerns relevant to management, such as patient outcomes as performance indicators.

Both HSR and ME are overlapping fields of study. Many investigators could claim either field as a professional identity. However, “managerial epidemiologist” is easier to pronounce than “health services researcher” and also most of our colleagues will recognize both of its component terms, whereas the latter phrase may generate blank looks.

Our sister journal, Journal of Primary Care and Community Health, also accepts HSR and ME studies. However, many of the investigators who produce these studies are in hospital-based specialties rather than primary care. Consequently, their research reports are scattered among hundreds of journals, each in its own medical specialty. A venue is needed that seeks the full range of HSR and ME articles, so that students and researchers can find many relevant examples in 1 location. Also, some clinical journals may regard HSR and ME study designs as lower in priority than the randomized clinical trial reports they favor.

Health Services Research and Managerial Epidemiology seeks a variety of article types. The original research category is for larger studies using complex analytical methods. Pilot studies are exploratory. Case studies may often be quasi-experiments. Quality improvement reports often will fit into the case study category. We employ a broad definition of quality improvement.² A quality improvement study that combines repeated-measures analysis of variance with qualitative assessment of the intervention would be an example of a case study.

We are pleased and excited to begin this new venture in medical publishing. Both HSR and ME are important fields that have not previously been the combined focus of a peer-reviewed journal. We welcome contributions from all specialties and all health professions.