Health Services Research

Health Services Research at UCSF. The first multidisciplinary health services research unit in the US was formed at UCSF when Philip R. Lee, then the Chancellor of UCSF, founded what would become the Philip R. Lee Institute for Health Policy Studies in 1972.

Today, the PRL-IHPS faculty combines a diverse group of social scientists (economists, sociologists, anthropologists, ethnographers, statisticians, etc.) with epidemiologists and clinicians from many fields. Pulmonologists have a long tradition with PRL-IHPS, with John Luce becoming the first pulmonary-health services fellow in the 1990s. One of our faculty, R. Adams Dudley, MD, MBA, is currently Associate Director of PRL-IHPS and in charge of the research portfolio.

PRL-IHPS faculty work in and often across three primary areas: Healthcare Systems, Population Health and Determinants, and Clinical Practice:

Healthcare System faculty examine outcomes, quality, and measurement of healthcare delivery systems with research and practice that spans from the individual clinic to hospital and healthcare systems. They also play a leadership role in translating research findings into policy, program, and healthcare delivery practices. PRL-IHPS faculty have informed the development of value-based purchasing approaches and have undertaken cost and cost-effectiveness studies across a wide domain of conditions and systems both domestically and internationally. Healthcare system faculty also conducts research on the healthcare workforce with a particular focus on nursing and primary care providers. The Institute is particularly interested in ensuring that our healthcare system delivers appropriate care to at-risk populations including children and the elderly.

Population Health and Determinants faculty focus on disparities in health and healthcare. Faculty examine how to ensure access to primary care for low-income populations in California and nationwide. For example, Institute faculty and staff work on shaping state and national policies related to reproductive health access. PRL-IHPS faculty use longitudinal data to examine chronic disease and its impact on vulnerable patients. Vulnerable populations are also a key focus of longstanding PRL-IHPS research and translational efforts related to substance use policy and tobacco control. Institute faculty have examined the impact of the environment on reproductive health outcomes and child health. Additionally, faculty study disasters – both natural and human-created – with a particular focus on health and the environment.

In Clinical Practice, PRL-IHPS has long been a leader in research and policy translation related to technology evaluation, drugs, and pharmaceuticals. The Institute boasts a path-breaking program on the production of research and medical evidence that touches on issues related to industry sponsorship, conflict of interest, and research integrity. In award-winning work, Institute faculty have developed and put into practice decision-making tools that facilitate the delivery of patient-centered care. PRL-IHPS is also at the forefront of understanding how genetic technologies and personalized medicine will shape and re-shape clinical practice of the future.

In all these areas, PRL-IHPS recognizes that policy problems are complex and are most effectively addressed by using the perspectives and tools of multiple disciplines and fields. However, different disciplines and fields use different “languages,” conceptual frameworks, methods, and standards of evidence. It is often difficult to bring lessons from one field into another and even more challenging to synthesize and translate research findings so that they can help inform decisions of policymakers, program managers, clinicians, and others concerned with health policy issues.

Over a period of 40 years, PRL-IHPS has demonstrated success in overcoming these disciplinary barriers to promote rigorous research translation into policy and practice. PRL-IHPS’ vibrant community of scholars from many disciplines, work effectively together to address critical health and health policy issues. Our unique contribution is our ability to apply a multi-disciplinary perspective in collaboration with others within and outside the Institute and UCSF. From its founding, PRL-IHPS has been a community where research from many disciplines is conducted, synthesized, and translated so that it can be applied to real-world policy arenas, program areas, and practice settings.