World Journal of Urology

, Volume 29, Issue 3, pp 273–276

Health services research in urology

  • Hua-yin Yu
  • William Ulmer
  • Keith J. Kowalczyk
  • Jim C. Hu
Topic Paper



Health services research (HSR) is increasingly important given the focus on patient-centered, cost-effective, high-quality health care. We examine how HSR affects contemporary evidence-based urologic practice and its role in shaping future urologic research and care.


PubMed, urologic texts, and lay literature were reviewed for terms pertaining to HSR/outcomes research and urologic disease processes.


HSR is a broad discipline that focuses on access, cost, and outcomes of Health care. Its use has been applied to a myriad of urologic conditions to identify deficiencies in access, to evaluate cost-effectiveness of therapies, and to evaluate structural, process, and outcome quality measures.


HSR utilizes an evidence-based approach to identify the most effective ways to organize/manage, finance, and deliver high-quality urologic care and to tailor care optimized to individuals.


Health services Outcomes Access Cost Quality 


  1. 1.
    Preparing for a career in health services research: opportunities for minority students (2009).
  2. 2.
    Litwin MS (2007) Outcomes research. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds) Campbell-Walsh urology, 9th edn. Elsevier, Amsterdam, pp 144–158Google Scholar
  3. 3.
    Kelley E, Moy E, Dayton E (2005) Health care quality and disparities: lessons from the first national reports. Med Care 43(Suppl 3):I1–I2PubMedGoogle Scholar
  4. 4.
    Kelley E, Moy E, Stryer D, Burstin H, Clancy C (2005) The national healthcare quality and disparities reports: an overview. Med Care 43(Suppl 3):I3–I8PubMedGoogle Scholar
  5. 5.
    Aday LA, Andersen RM (1981) Equity of access to medical care: a conceptual and empirical overview. Med Care 19(12):4–27CrossRefGoogle Scholar
  6. 6.
    The Dartmouth atlas of health care (2011).
  7. 7.
    Goodman DC, Chang CH, Fisher ES (2010) Regional and racial variation in primary care and the quality of care among medicare beneficiaries.
  8. 8.
    Demark-Wahnefried W, Strigo T, Catoe K, Conaway M, Brunetti M, Rimer BK, Robertson CN (1995) Knowledge, beliefs, and prior screening behavior among blacks and whites reporting for prostate cancer screening. Urology 46(3):346–351PubMedCrossRefGoogle Scholar
  9. 9.
    Jayadevappa R, Chhatre S, Johnson JC, Malkowicz SB (2010) Variation in quality of care among older men with localized prostate cancer. Cancer [Epub ahead of print]Google Scholar
  10. 10.
    Fitzpatrick P, Corcoran N, Fitzpatrick JM (1998) Prostate cancer: how aware is the public? Br J Urol 82(1):43–48PubMedGoogle Scholar
  11. 11.
    de Wit R, Fizazi K (2006) Controversies in the management of clinical stage I testis cancer. J Clin Oncol 24(35):5482–5492PubMedCrossRefGoogle Scholar
  12. 12.
    Routh JC, Grant FD, Kokorowski P, Lee RS, Fahey FH, Treves ST, Nelson CP (2010) Costs and consequences of universal sibling screening for vesicoureteral reflux: decision analysis. Pediatrics 126(5):865–871PubMedCrossRefGoogle Scholar
  13. 13.
    Donabedian A (1966) Evaluating the quality of medical care. Milbank Mem Fund Q 44(Suppl 3):166–206PubMedCrossRefGoogle Scholar
  14. 14.
    Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE (2002) Hospital volume and surgical mortality in the United States. N Engl J Med 346(15):1128–1137PubMedCrossRefGoogle Scholar
  15. 15.
    Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL (2003) Surgeon volume and operative mortality in the United States. N Engl J Med 349(22):2117–2127PubMedCrossRefGoogle Scholar
  16. 16.
    Hu JC, Gold KF, Pashos CL, Mehta SS, Litwin MS (2003) Role of surgeon volume in radical prostatectomy outcomes. J Clin Oncol 21(3):401–405PubMedCrossRefGoogle Scholar
  17. 17.
    Semel ME, Resch S, Haynes AB, Funk LM, Bader A, Berry WR, Weiser TG, Gawande AA (2010) Adopting a surgical safety checklist could save money and improve the quality of care in US hospitals. Health Aff 29(9):1593–1599CrossRefGoogle Scholar
  18. 18.
    Weiser TG, Haynes AB, Lashoher A, Dziekan G, Boorman DJ, Berry WR, Gawande AA (2010) Perspectives in quality: designing the WHO Surgical Safety Checklist. Int J Qual Health Care 22(5):365–370PubMedCrossRefGoogle Scholar
  19. 19.
    The leapfrog group (2011).
  20. 20.
    Hanchanale VS, Javle P (2010) Impact of hospital provider volume on outcome for radical urological cancer surgery in England. Urol Int 85(1):11–15PubMedCrossRefGoogle Scholar
  21. 21.
    Lavery HJ, Brajtbord JS, Levinson AW, Nabizada-Pace F, Pollard ME, Samadi DB (2010) Unnecessary imaging for the staging of low-risk prostate cancer is common. Urology [Epub ahead of print]Google Scholar
  22. 22.
    Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A, Bratzler DW (2007) Public reporting and pay for performance in hospital quality improvement. N Engl J Med 356(5):486–496PubMedCrossRefGoogle Scholar
  23. 23.
    Madeb R, Golijanin D, Noyes K, Fisher S, Stephenson JJ, Long SR, Knopf J, Lyman GH, Messing EM (2009) Treatment of nonmuscle invading bladder cancer: do physicians in the United States practice evidence based medicine? The use and economic implications of intravesical chemotherapy after transurethral resection of bladder tumors. Cancer 115(12):2660–2670PubMedCrossRefGoogle Scholar
  24. 24.
    Shahinian VB, Kuo YF, Gilbert SM (2010) Reimbursement policy and androgen-deprivation therapy for prostate cancer. N Engl J Med 363(19):1822–1832PubMedCrossRefGoogle Scholar
  25. 25.
    Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, Wei JT (2008) Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 358(12):1250–1261PubMedCrossRefGoogle Scholar
  26. 26.
    Albertsen PC, Fryback DG, Storer BE, Kolon TF, Fine J (1005) Long-term survival among men with conservatively treated localized prostate cancer. JAMA 274(8):626–631CrossRefGoogle Scholar
  27. 27.
    Porter MP, Wei JT, Penson DF (2005) Quality of life issues in bladder cancer patients following cystectomy and urinary diversion. Urol Clin North Am 32(2):207–216PubMedCrossRefGoogle Scholar
  28. 28.
    Krupski TL, Saigal CS, Litwin MS (2003) Variation in continence and potency by definition. J Urol 170(4 Pt 1):1291–1294PubMedCrossRefGoogle Scholar
  29. 29.
    Schroeck FR, Krupski TL, Sun L, Albala DM, Price MM, Polascik TJ, Robertson CN, Tewari AK, Moul JW (2008) Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy. Eur Urol 54(4):785–793PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hua-yin Yu
    • 1
  • William Ulmer
    • 1
  • Keith J. Kowalczyk
    • 1
  • Jim C. Hu
    • 1
    • 2
  1. 1.Division of Urology, Department of SurgeryBrigham and Women’s/Faulkner Hospitals, Harvard Medical SchoolBostonUSA
  2. 2.Center for Surgery and Public Health, Brigham and Women’s/Faulkner Hospitals, Harvard Medical SchoolBostonUSA

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