[APPLIED] CRITIQUE 1
Research Critique: Mixed-Methods Research
Yvonne Haddock
School of Education, Liberty University
Research Critique: [Applied] Research Introduction
[APPLIED] CRITIQUE 2
While praising the multi-method approach and index development in Cabrera-Barona et
al.'s (2017) study on healthcare in Quito, the critique raises concerns. It questions whether the
findings can be applied elsewhere and suggests further research to confirm the indices' broader
validity. Moreover, it urges a deeper exploration of social factors impacting healthcare access
and satisfaction for suitable policy and research insights.
Summary
Purpose
The Cabrera-Barona et al. (2017) study aimed to evaluate how social and health-related
factors impact people’s experiences with healthcare. Recognizing the complexities of
accessibility and satisfaction, they went beyond simple metrics and developed comprehensive
“composite indices.” These indices combined objective data, like distance to healthcare facilities,
with subjective information gathered through surveys, capturing how people perceived their
access and level of satisfaction. The researchers employed a "mixed-methods" approach,
strategically blending quantitative and qualitative data sources. They conducted surveys to gauge
people's opinions and experiences while incorporating the valuable insights of expert
professionals in the healthcare field. This multifaceted approach allowed them to paint a holistic
picture of the situation.
Participants/Sample
The participants comprised the residents of Quito, Ecuador. To ensure a representative
sample, they used a two-step selection process. First, they broadly divided the city into distinct
areas. Then, they randomly selected individuals within each region to participate in the study.
This resulted in 471 individuals who completed questionnaires, providing valuable insights from
[APPLIED] CRITIQUE 3
a diverse range of residents. However, the researchers recognised the importance of
incorporating expert perspectives. So, they recruited 38 experts in the healthcare field to
participate in an "analytical hierarchy process" (AHP). This method allowed the experts to
systematically analyze and weigh various factors influencing healthcare accessibility and
satisfaction, enriching the understanding with their specialized knowledge.
Research Design
The research design adopted was a “mixed-methods” approach, valuing both the breadth
of quantitative data and the depth of qualitative insights. They distributed surveys to capture the
quantitative perspectives of a broad range of participants, collecting numerical data on their
experiences with healthcare accessibility and satisfaction. Additionally, they leveraged the
qualitative expertise of 38 healthcare professionals using the “analytical hierarchy process”
(AHP) method. This allowed the experts to weigh and analyze various factors influencing
accessibility and satisfaction, providing valuable in-depth understanding. Finally, the researchers
employed regression analyses to draw meaningful connections between the collected data and
understand the bigger picture. This powerful statistical technique helped them identify specific
social and health-related factors that significantly explained the variations in the developed
composite indices for accessibility and satisfaction.
Method of Data Collection
The data collected in this study consisted of surveys and an online questionnaire filled out
by experts. The process was done in Quito, where the researchers gathered information for five
weeks. The surveys included multiple-choice, Likert scale, and open-ended questions to
understand people's views on healthcare access, satisfaction, and background details.
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Method of Analysis
The researchers ran/conducted a trio of analytical tools: linear relationships, satisfaction
likelihood, and complex interaction exploration. The first investigated how factors like income
directly impacted people's scores, while the second looked at how specific characteristics
affected someone's chances of being highly satisfied. Finally, the powerhouse tool revealed
hidden connections between various factors and how they influenced access and satisfaction.
This deep dive into the social and health-related influences provided policymakers with valuable
insights to craft interventions and improve healthcare for all residents of Quito.
Results
The study found that people in different parts of Quito had unequal access to and
satisfaction with healthcare. For example, people in the North and West regions had lower
average accessibility and satisfaction scores than those in the South and East regions.
Additionally, the study showed that social factors like education, marital status, and health
insurance were linked to healthcare access and satisfaction. For instance, people with higher
education or health insurance had higher accessibility and satisfaction scores compared to those
with lower education or no insurance. These findings suggest that there are healthcare disparities
in Quito and that social factors play a role in these disparities.
Critical Analysis
Further Research
The study by Cabrera-Barona et al. (2017) provides valuable insights into healthcare
accessibility and satisfaction, incorporating objective and subjective measures. The mixed-
methods approach enhances the study's comprehensiveness, allowing for a nuanced
understanding of healthcare disparities. However, the generalizability of the findings may be
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limited to the specific context of Quito, and further research is needed to validate the indices in
other settings. Future research could explore the applicability of the composite index developed
in this study to other regions and healthcare systems. Additionally, longitudinal studies could
investigate the temporal dynamics of healthcare accessibility and satisfaction, considering
population demographics and healthcare policy changes.
Threats to Validity/Undocumented Bias
Unveiling healthcare inequalities in Quito, Cabrera-Barona et al. (2017) masterfully
blend objective and subjective data. This combined approach paints a rich picture of the city's
healthcare landscape, highlighting disparities. While the study's strength lies in its context-
specific understanding, further exploration is crucial to validate its findings elsewhere.
Expanding the reach of these "composite indices" to diverse regions and healthcare systems
could offer valuable insights. Tracking changes over time through longitudinal studies would add
another layer of understanding, revealing how populations and policies impact healthcare access
and satisfaction.
Original Insight/Criticism
Unveiling healthcare's hidden dimensions, the study sheds light on incorporating
subjective experiences alongside objective data. Yet, delving deeper into the "why" behind social
factors' impact on healthcare access and satisfaction would unlock even richer insights.
Implications of Findings
[APPLIED] CRITIQUE 6
Unequal access and unequal satisfaction: the study's findings guide policymakers towards
targeted interventions, crafting fairer healthcare for all. Understanding the "why" behind
disparities empowers them to build a more equitable system.
Discussion
Unveiling healthcare realities, Cabrera-Barona et al. (2017) blend data and methods to
build a nuanced picture of access and satisfaction, even creating "composite indices." They offer
valuable insights, but validating these findings and diving deeper into "why" disparities exist
requires further exploration.
