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The Health Services and Outcomes Research (HSOR) unit was established in 2005, as part of the National Healthcare Group.
Our vision is to add years of healthy life to the people of Singapore through excellence in Health Services Research.
Our mission is to improve the quality of healthcare by providing best available evidence for decision making and knowledge translation; and build capacity and advance knowledge in Health Services Research.
What is Health Services Research (HSR)?
A multidisciplinary field of inquiry, both basic and applied, that examines the use, costs, quality, accessibility, delivery, organisation, financing, and outcomes of health care services, to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.
(Institute of Medicine Report, 1995)
A multidisciplinary field of scientific investigation that studies how social factors, financing systems, organisational structures and processes, health technologies, and personal behaviors that affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organisations, institutions, communities, and populations.
(AcademyHealth, 2000)
HSR examines how people get access to health care, how much care costs, and what happens to patients as a result of this care. The main goals of health services research are to identify the most effective ways to organise, manage, finance, and deliver high quality care; reduce medical errors; and improve patient safety.
(Agency for Healthcare Research and Quality, 2002).
What is Outcomes Research?
Outcomes research seeks to understand the end results of particular health care practices and interventions. End results include effects that people experience and care about, such as change in the ability to function. In particular, for individuals with chronic conditions—where cure is not always possible—end results include quality of life as well as mortality. By linking the care people get to the outcomes they experience, outcomes research has become the key to developing better ways to monitor and improve the quality of care. For clinicians and patients, outcomes research provides evidence about benefits, risks, and results of treatments so they can make more informed decisions. For health care managers and purchasers, outcomes research can identify potentially effective strategies they can implement to improve the quality and value of care.
(Agency for Healthcare Research and Quality, 2002)
History and Development
In July 2004, the Chairman and CEO of the National Healthcare Group (NHG) led a team on a study trip to established healthcare institutions in the United States. The trip served to acquire first-hand information and knowledge on successful integrated delivery systems and healthcare systems. The focus was on systems that made a significant impact on improving quality of patient care while keeping costs under control.
The key learning point was that HSR provided the scientific basis for these improvements. This was most apparent in the Veterans Administration (VA) Systems that engaged the expertise of RAND Health in developing its strategic prioritisation of programmes. Through structured data collection and analysis, sound methodologies were used to answer clinical quality questions and improve policy and decision-making. It was recognised that HSR could play a significant role in improving health outcomes and quality of care in NHG.
In January 2005, Chairmen of various Medical Boards within the NHG endorsed the concept and scope of HSR. In September 2005, the Health Services and Outcomes Research (HSOR) unit was set up within the NHG with a team of 5 staff.
The unit has grown considerably. It now comprises a multi-disciplinary team from various backgrounds such as medicine, epidemiology, public health, nursing, physiotherapy, operations research, medical informatics, biostatistics, economics and social sciences. The team has presented and won awards at local and overseas conferences, such as NHG Annual Scientific Congress, ISPOR and AcademyHealth Annual Research Meeting. In 2008, HSOR became the first collaborating center of the Joanna Briggs Institute in Singapore, specializing in the field of Evidence Based Health Services Management.