Qualitative + quantitative = greater value

Editor’s note: Wayne Howard is managing director of Wayne Howard & Associates, a Claremont, Calif., health care marketing research and consulting firm.

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 forces users to choose between them.

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 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 didn’t know which ones to target. Interestingly, a major competitor had recently cut certain benefits, supposedly after having done some research on the matter.

The results of the competitor’s benefit cuts were disastrous and soon after making the reductions and experiencing substantial member disenrollments, the competitor rescinded its changes. Our client asked for a proposal for a survey research project that would help it avoid a similar error.

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 regular focus groups would have entailed.

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 responses. Additionally, we were able to use the discussions to refine our respondent incentives for the planned survey.

The next step was a stratified random sample survey that exceeded a 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 with which certain benefits were clearly identified as ideal candidates for reduction while others were recognized as potential causes for disenrollments and likely barriers to new enrollments.

The cost of the overall research, using linked methodologies, was little more than a typical mail survey and completed within a comparable time frame.

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 happened quickly, compounding a rather challenging situation.

We were asked to provide an appropriate research design, conduct the research, report our findings and make recommendations. The 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 quality information would be obtained and that all research would be accomplished on a timely and cost-effective basis.

The research plan involved two 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. Using this approach, data collection was completed in about six weeks, a timeline necessary for meeting target dates for presenting findings and recommendations.

Throughout the research effort we evaluated the linkage of the research methodologies to assure that what we learned from one segment could be used to our 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 successful study.

The scope of the research possibly could cause some concern about 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.

This time-saving 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:

  • Plan and prioritize overall research goals within well-defined constraints.
  • Choose a single research supplier properly qualified for all research needed.
  • Identify and exploit important opportunities to enhance quality and cost-effectiveness.
  • Assure that analyses and findings reflect an appropriate balance of methodologies used.