Books

Published: 28/02/2002, Volume II2, No. 5794 Page 30 31

Studying the Organisation and Delivery of Health Services: research methods

Edited by Naomi Fulop, Pauline Allen, Aileen Clarke and Nick Black

Publisher: Routledge. ISBN: 0415257638. 240 pages.£16.99.

Managers whose bookshelves are creaking under the weight of research method texts may balk at the thought of yet another addition, yet I would urge them to find space for this slim volume.

It consists of an editorial introduction and a series of contributed chapters by experts from a subset of research disciplines, including epidemiology, organisational studies and policy analysis.

The book avoids the problem of unevenness by adopting a common framework for the edited chapters.

Each contains a description of the theoretical basis of the discipline, an overview of the research questions commonly addressed, with referenced examples, and an examination of research methods used within the discipline.

So far, so ordinary.The value and timeliness of this book lies in the strong case made for diversity and inclusivity in research design, in the context of the growing interest in evaluations of service delivery.

While the evaluation of new therapies remains important, there is increasing recognition of the part played by the organisation and delivery of therapies in realising the full benefit of treatments.

The provision of major national funding in the UK's Service Delivery and Organisation research programme is evidence of the seriousness with which this view is held.

However, there are serious challenges ahead in SDO research, as it seeks to draw on distinct research traditions in the social sciences, with marked tendencies toward fragmentation and the prospect of 'paradigm wars'.

The editor steers a clear course through the difficulties of interdisciplinary collaboration, navigating by means of methodological pragmatism.This they outline in the opening chapter with a concrete example of tele-orthopaedics within primary care: its diagnostic accuracy compared to outpatient provision assessed by a randomised-controlled trial (epidemiology) and its impact on the patient-GP relationship assessed by observational techniques (microsociology).

While this middle course is nothing new, the use of concrete examples builds into a compelling case for all those involved in SDO programmes. It is a truism that to those with a hammer, all things appear to be nails.

This volume leads the reader gently to the toolbox, offering guidance for their proper application.

Though primarily aimed at the research community, several chapters will be of interest to students of research methods, particularly the chapter on synthesising research evidence.This contains an excellent table comparing schemas for assessing the quality of qualitative health services research.Definitely worth the cover price.