1.M. Workshop: Health Services Research in Europe: time to dust off the field
Authors:   Organised by: Arènes research unit (UMR CNRS 6051: team INSERM U1309),   Chair persons: Eric Breton (France)
Published: October 2023

Since the 90s, and in spite of major transformations in health systems and the new challenges they face (e.g. rising social inequities, labour shortages), the health Services Research (HSR) field has seen little evolution in the definition of the ground it covers. In 2021, researchers from the EHESP School of Public Health (France) launched a CNRS- and INSERM-funded research team devoted to Health Services and Management Research. To mark the event, a seminar was held to reflect on what HSR stands for today and the specific contributions of our team to the field. In this workshop, Eric Breton will first briefly present the summary of the conclusions of the seminar and the topic areas our research team addresses. He will point to the specificities of HSR in the context of strong European welfare regimen and the importance of recognising the impact upstream social determinants of health have on health systems. We will then move on to our panellists who will, through their own research, question the current perspectives on HSR and highlight new advances in methodological approaches and tools at hand. Here is the list of topic we will cover. For our first panellist, Nicolas Sirven, the HSR scene is witnessing the coming of age of public policy evaluations in Europe, which is reflected in enhanced capacities to inform health system governance. He will argue that European health systems are increasingly collecting and giving access to large datasets. These datasets stand out as they cover whole populations or at least large shares of them. They will stress the importance of making the best of new evaluation approaches and methods that not only inform on impacts and outcomes but also on contextual conditions for policies to deliver. Drawing lessons from his work on access to kidney transplantation waiting list, Latame Komla Adoli will raise the issue of gender discrimination in health services. After presenting the evidence of this gender gap, he will demonstrate the capacity of HSR to provide valuable insights on how to close the gender gap and the importance of combining bio-statistical analyses with qualitative investigations. Nolwenn Le Meur-Rouillard will share insights on how big data and new data collection tools are opening up a new landscape for HSR. E-health devices, social networks, and electronic medical records (EHR) are all sources that can feed HSR making possible ‘real-life’ longitudinal studies on the entire population of a territory. This is offering a renewed vision of the disparities in access to and use of healthcare services. Carla Perrota, from the University College Dublin will conclude the workshop by offering some general remarks on the French HSR agenda and provide an account of her vision on the future of HSR. This interactive workshop will be facilitated by a web-based survey tool to further engage members of the audience. Highlights of the workshops will be published in a short paper.

Key messages

• Most definitions of health services research limit investigation to health care services; a situation that does not reflect the scope of actions of the strong welfare systems of Europe.

• From a social determinant of health perspective, health services research needs to address programmes and policies governments deliver beyond health care to promote population health and equity.