Research in Health Care

I K Crombie with H T O Davies Wiley, £14.99, pp 302 ISBN 0 471 96259 7

The aim of research in health care is to improve the quality of health services as well as the use of resources. Not much attention was given to these problems a few decades ago, but health services research has become increasingly important. It deals with the health sector, its functions and services, and the health needs of the population. The disproportion between, on the one hand, what is now medically and technically feasible, and, on the other, what development within society makes economically possible, makes the need for health service research more urgent than ever-especially when such research incorporates sociology, education, and economics.

Taking an epidemiological approach, Crombie and Davies have written an ambitious textbook on health services research that tries to cover all aspects of the process, from the first idea through data collection and analysis to the communication of results.

The broad scope means that the various sections are not always extensively covered, and sometimes the subjects are presented almost as a condensed manual. Nevertheless, introductory texts to health service research are scarce, so this book is important as an easily read and illustrative guide to the use of epidemiological methods. It provides good examples of applied health service research, and has an up to date list of relevant references, especially British and American. The sections on qualitative research methods, economy, sociology, and health promotion are too short, and could be extended in future editions. The same applies to the section on the use of routinely collected data, though such sources are some of the most essential for health services research. The chapters on epidemiological methods have a very schematic and academic layout, and the terminology and interpretation of certain epidemiological concepts are perhaps not always up to date. The brevity of the text does not allow for nuances.

Despite these drawbacks, the book is an excellent introduction for readers who want to become acquainted with an epidemiological approach to health service research, and it deserves wide distribution among future researchers in this subject.-HENRIK TOFT SORENSEN, associate professor of epidemiology, Aarhus University, Denmark