Linking Research Methodologies
Qualitative + Quantitative = Greater Value

By Wayne Howard

Editors note: Wayne Howard, Managing Director of his Claremont, California based health care marketing research and consulting firm, can be reached at 1-800-803-7296 or at info@waynehoward.com.

Most health care organizations have faced mounting pressures to improve their marketing results while operating within reduced budgets. Our firm specializes in meeting marketing research needs for the health care industry so we understand the challenges posed by doing more with less in a fiercely competitive marketing environment too often made even more challenging by adverse legislation.

During more than 15 years of providing research services we have seen great diversity in client needs for research and have responded with survey research, focus groups, one-on-one interviews, service audits, small-scale quantitative studies and other methods.

Focus group and survey research services gradually have emerged as the two most popular examples of qualitative and quantitative research. Choosing between surveys and focus groups can require seemingly little thought because typical applications, benefits and limitations of either are widely recognized by research suppliers and buyers.

Not so widely understood however is that superior results often can be achieved more cost-effectively by avoiding the tendency to pit quantitative against qualitative in a manner that assumes their mutual exclusivity and leads to a “choosing between them” approach.

Most decision-makers probably would not argue with the assertion that a combination of focus group and survey research can produce better results compared to using either approach separately. Strong arguments would likely come with a second assertion that a combined approach can be shown as being more cost-effective.

A final aspect of a combined approach, sure to be an issue for many, involves time constraints for conducting research. As we consider the possibility of combining qualitative and quantitative approaches to produce research that generates better quality information that is more cost-effective, examples based on actual case histories may be helpful.

Deciding Which Benefits To Reduce…

Our client, a Medicare HMO, needed to reduce benefits but was uncertain as to which ones. Interestingly, a major competitor of the client had recently cut certain benefits after supposedly having done some research.

The results were disastrous and within a short time after making benefit reductions and experiencing substantial member disenrollments, the competitor was forced to rescind their changes.  Our client did not wish to make a similar error so we were asked to provide a proposal for survey research to accomplish the indicated need.

After some discussion, we prepared a research plan based on a combination of qualitative and quantitative research that we had previously found to be effective---a series of small group discussions at local senior centers as a prelude to a mail survey. The small group discussions were organized and conducted in a fraction of the time and cost that would have been involved with regular focus groups.

This qualitative component of the research ensured that we asked the appropriate questions in our proposed survey and asked them in the best possible way. This effort also helped us better anticipate responses to some open-ended questions and guide us in the interpretation of such response. Additionally, we were able to use the discussions to refine our response incentives for the planned survey.

The next step was a stratified random sample survey that exceeded 40 percent response, resulting in a wealth of needed information from health plan members and non-members. Our client was pleased with the relative ease that certain benefits were clearly identified as ideal candidates for reduction while others were recognized as potential trigger points for disenrollments and likely barriers to new enrollments.

The cost of the overall research was little more than a typical mail survey and completed within a comparable time frame. The end result of this effort was another of our quite successful research projects using linked methodologies. 

Resolving Hospital Market Information Needs In Multiple Segments

A well-established hospital, part of a relatively large non-profit system, had experienced some abrupt changes in its top management. Subsequently, many doctors were reported to lack confidence in the hospital and its seemingly unstable management.

Employee morale was said to be low and a new hospital had just opened nearby and had quickly gained patients via effective managed care contracting. All of these events had taken place within a relatively short period, compounding a rather challenging situation.

We were asked to provide an appropriate research design, conduct the research, report our findings and make recommendations. The nature of this situation immediately suggested a research approach that would address all relevant market segments and generate critical information needed for strategic and tactical decision-making.

It was also apparent that the research plan would require linked methodologies, closely coordinated, to assure that the quality of information needed would be achieved and that all research would be accomplished on a timely and cost-effective basis.

The overall research plan involved 2 focus groups, a random sample telephone survey of 400 community residents, a dozen physician interviews and a survey of about 700 hospital employees.

Focus groups were needed to initially identify and clarify certain issues and feed other research components conducted on an almost concurrent basis. This approach enabled all data collection to be completed in about 6 weeks, a timeline necessary for meeting target dates for presenting findings and recommendations.

Throughout the overall research effort we were able to continually evaluate the linkage of the research methodologies to assure that what we learned from one segment could be used to advantage in another. For example, doctor comments found application in the community phone survey, as did employee inputs. This synergistic approach also facilitated the interpretation of the end results for this quite successful study that accomplished its specified goals and even more.

The scope of the research described possibly could cause some concern with regard to both total cost and cost-effectiveness. We stated earlier that linked methodologies could achieve improved cost-effectiveness. A key assumption is that the research buyer is dealing with a single research supplier capable of supplying both quantitative and qualitative services.

Typically, this can reduce total costs and improve cost-effectiveness in several ways. First, if a single research firm is responsible for all research, this enables a consolidation of research administration and other efforts as opposed to two different firms involved with a set of parallel tasks.

The resulting timesaving is substantial with regard to communications and coordinations, preparing a single report rather than having separate reports and various other segregated work elements that otherwise could be easily integrated.

This timesaving translates to lower costs via using linked methodologies for overall assessments as compared to research micromanagement that addresses each element independently. Another important gain of this approach is the savings of managerial time in dealing with a single research vendor rather than multiple vendors.

The cost-savings associated with the preceding factors can be dwarfed by the value derived from having a single qualified research firm responsible for integrated research planning, data collection, analysis and interpretation of quantitative and qualitative research results. We recommend four steps as a framework for linking methodologies:

In summary, we encourage health care decision-makers to strongly consider effectively linking qualitative and quantitative methodologies to increase the potential value to be gained from their next research effort.

Reprinted from Quirk's.

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