Using the right tools to answer the right questions: the importance of evaluative research techniques for health services evaluation research in the 21st century

Because of the marked changes in health care expenditures in recent years, there has been a call for greater accountability in the area of health education, policy, services and reform. In recent years, evaluative research has been conducted in health arenas under the rubric of health services research. Health services research methods have not evolved from evaluation research methodology, but rather have adopted methods that often do not lend themselves to deriving appropriate causal inferences in multi-causal environments.