Intended for healthcare professionals

Education And Debate

Qualitative Research: Case study evaluation

BMJ 1995; 311 doi: (Published 12 August 1995) Cite this as: BMJ 1995;311:444
  1. Justin Keen, research fellow, health economics research groupa,
  2. Tim Packwooda
  1. Brunel University, Uxbridge, Middlesex UB8 3PH
  1. aCorrespondence to: Dr Keen.

    Case study evaluations, using one or more qualitative methods, have been used to investigate important practical and policy questions in health care. This paper describes the features of a well designed case study and gives examples showing how qualitative methods are used in evaluations of health services and health policy.

    This is the last in a series of seven articles describing non-quantitative techniques and showing their value in health research


    The medical approach to understanding disease has traditionally drawn heavily on qualitative data, and in particular on case studies to illustrate important or interesting phenomena. The tradition continues today, not least in regular case reports in this and other medical journals. Moreover, much of the everyday work of doctors and other health professionals still involves decisions that are qualitative rather than quantitative in nature.

    This paper discusses the use of qualitative research methods, not in clinical care but in case study evaluations of health service interventions. It is useful for doctors to understand the principles guiding the design and conduct of these evaluations, because they are frequently used by both researchers and inspectorial agencies (such as the Audit Commission in the United Kingdom and the Office of Technology Assessment in the United States) to investigate the work of doctors and other health professionals.

    We briefly discuss the circumstances in which case study research can usefully be undertaken in health service settings and the ways in which qualitative methods are used within case studies. Examples show how qualitative methods are applied, both in purely qualitative studies and alongside quantitative methods.

    Case study evaluations

    Doctors often find themselves asking important practical questions, such as should we be involved in the management of hospitals and, if so, how? how will new government policies affect the lives of our patients? and how can we cope with changes …

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