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Health risk appraisal: its role in health services research.

I was asked to address the issue of how health services researchers and people addressing health risk assessment can relate to each other. This led me to think about what health services research means-a difficult question for me to answer because I specialize in one relatively narrow component of that rather broad field. I looked at health services research as the application of decision science and interactive computing to the description, measurement, modeling, and facilitation of problem solving related to the health of people. To compensate for this narrow perspective, I listened carefully to the discussions in this meeting, talked to several people associated with the National Center for Health Services Research (NCHSR) about the kind of projects they support, and examined the titles of research articles appearing on the publication lists prepared by the NCHSR. In reviewing those titles, I found topics such as: outcome evaluation, decision making, computer-based medical diagnosis, intensive care triage, technology assessment; efficacy of patient management processes, screening tools, measures of severity, quality of care, and so on. So the NCHSR has supported a variety of studies examining the effectiveness of health care delivery systems. Probably the single area receiving the most attention is cost containment.) Table 1 summarizes