The first question many people ask about our new Healthcare Delivery Research Program concerns the title. Why was the term “healthcare delivery research” used? Below are some of my personal reflections about this choice of terminology.
I came to NCI to serve as Chief of the Health Services and Economics Branch. There were two other Branches focused on work that could be considered to fall mainly under the rubric of “health services research.” They were the Outcomes Research Branch and the Patterns of Care Research Branch. I was concerned that combining the three groups into a “Health Services Research Program” would fail to indicate the expansion of this field of research within the Division of Cancer Control and Population Sciences (DCCPS).
Throughout the fall of 2015, I and others began to talk about plans to create a new group within the Division of Cancer Control and Population Sciences. We heard from some national research leaders that the term “health services research” was poorly understood by those outside the field. The leaders we spoke with noted that a number of organizations had moved away from “health services research” to other titles. An examination of department names at public health schools throughout the country showed that health services research was often conducted in departments with names including “health” plus “management” and/or “policy.” A name along those lines is not a possibility because NCI neither manages care nor creates policy.
Something else became apparent to me as we began to identify the gaps our new program would address. With apologies for sweeping generalizations, the focal points of the other three DCCPS programs are individual behavior, population health, and surveillance. Our program is the only one to focus on providers, practice settings, financing, health policy impacts, etc. Whereas our colleagues in other programs are interested in intervening with specific people and populations, we want to encourage interventions targeting providers and practice settings. This is what NCI can do – support the generation of evidence that can be used to manage care and create policies.
My hope is that the phrase “healthcare delivery” will be easily understood by my colleagues at NCI, researchers in other fields, and the lay public. Everyone receives care at some point and hopefully can imagine how research might improve how care is delivered. Those who have followed recent health care reform efforts likely recognize the need for more and better evidence to guide future reform. By distinguishing our interests from those of our DCCPS and NCI colleagues, the phrase should help members of the extramural community identify where they can find information about funding opportunities and programmatic priorities. The phrase may draw the attention of medical anthropologists, organizational psychologists, and other experts who might not consider themselves traditional health services researchers yet can make important contributions to understanding and improving health care delivery.
What would you have called it? And why?