Research Methodology

Journal supplement explores the use of qualitative methods in health services research

For the past several years, the Agency for Healthcare Research and Quality has been grappling with how to foster qualitative research. In December of 1998, AHRQ's Center for Organization and Delivery Studies coordinated and cosponsored an invitational conference on qualitative methods in health services research with the Robert Wood Johnson Foundation. The conference brought together qualitative and quantitative researchers from within the field of health services research and from the basic and applied social sciences to discuss qualitative research methods, their applications in health services research, and ways of improving the "quality" of qualitative research.

The presented papers and discussion papers from the conference are now being shared with the broader health services research community through a special supplement to the December 1999 issue of the journal Health Services Research. This thought-provoking issue provides a rich resource for both quantitative and qualitative researchers interested in examining fundamental research design and methods issues.

An editorial by Stephen M. Shortell, Ph.D., challenges the field to remove the barriers that constrain investigators' ability to conduct and disseminate well-done qualitative research. He argues that the field needs to move beyond the debate over the relative merits of quantitative and qualitative research to produce findings that can be used to improve the financing, organization, delivery, and outcomes of care. Increasingly, this may involve the creative combination of quantitative and qualitative methods.

In addition to Dr. Shortell's editorial, the supplement also contains the following articles:

• An introduction, pp. 1091-1099, by Thomas Rundall, Kelly Devers, and Shoshanna Sofaer provides background information on the conference and sets the stage for the papers that follow.
• "Qualitative methods: What are they and why use them?" pp. 1101-1118, by Shoshanna Sofaer, provides an overview of why and how qualitative methods have been used and can be used in health services and health policy research, describes a range of specific methods, and gives examples of their application.
• "Qualitative research and the profound grasp of the obvious," pp. 1119-1136, by Robert Hurley, discusses the views of four respected researchers on the value of promoting coexistent and complementary relationships between qualitative and quantitative research methods.
• "The distinctiveness of case-oriented research," pp. 1137-1152, by Charles Ragin, argues that important and often overlooked distinctions between quantitative and qualitative research, which he labels "case-oriented" and "variable-oriented" research (respectively), are differences in their goals and strategies.
• "How will we know 'good' qualitative research when we see it? Beginning the dialogue in health services research," pp. 1153-1188, by AHRQ researcher Kelly Devers, lays the foundation for an explicit review and dialogue about the criteria that should be used to evaluate qualitative health services research. Reprints (AHCPR Publication No. 00-R011) are available from AHRQ's Publications Clearinghouse.
• "Enhancing the quality and credibility of qualitative analysis," pp. 1189-1208, by Michael Quinn Patton, examines ways of enhancing the quality and credibility of qualitative analysis by dealing with three distinct but related concerns: rigorous methods, the credibility and competency of the researcher, and the philosophical beliefs of evaluation users.
• "Enhancing the quality of case studies in health services research," pp. 1209-1224, by Robert K. Yin, provides guidance on improving the quality of case studies and explains how the case study method can become a valuable tool for health services research.
• "Using qualitative comparative analysis to study causal complexity," pp. 1225-1239, by Charles Ragin, discusses why and how different combinations of causal conditions lead to the same outcome and ways qualitative research can contribute to understanding in these circumstances.
• "Analyzing qualitative data with computer software," pp. 1241-1263, by Eben A. Weiztman, presents an overview of the qualitative data analysis process and the role of software within it, provides a principled approach to choosing among software packages, discusses the potential benefits and limitations of such software, and forecasts some of the developments that can be expected in the field in the near future.

A limited number of free copies of the special supplement, Publication No. OM 99-0017, are now available from AHRQ's Publications Clearinghouse.

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