• Health services;
  • research methodology;
  • mixed methods;
  • qualitative methods


Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of methodological components indicative of rigorous approaches across mixed methods, qualitative, and quantitative articles.

Data Sources

All empirical articles (= 1,651) published between 2003 and 2007 from four top-ranked health services journals.

Study Design

All mixed methods articles (= 47) and random samples of qualitative and quantitative articles were evaluated to identify reporting of key components indicating rigor for each method, based on accepted standards for evaluating the quality of research reports (e.g., use of p-values in quantitative reports, description of context in qualitative reports, and integration in mixed method reports). We used chi-square tests to evaluate differences between article types for each component.

Principal Findings

Mixed methods articles comprised 2.85 percent (= 47) of empirical articles, quantitative articles 90.98 percent (= 1,502), and qualitative articles 6.18 percent (= 102). There was a statistically significant difference (χ2(1) = 12.20, = .0005, Cramer's = 0.09, odds ratio = 1.49 [95% confidence interval = 1,27, 1.74]) in the proportion of quantitative methodological components present in mixed methods compared to quantitative papers (21.94 versus 47.07 percent, respectively) but no statistically significant difference (χ2(1) = 0.02, = .89, Cramer's = 0.01) in the proportion of qualitative methodological components in mixed methods compared to qualitative papers (21.34 versus 25.47 percent, respectively).


Few published health services research articles use mixed methods. The frequency of key methodological components is variable. Suggestions are provided to increase the transparency of mixed methods studies and the presence of key methodological components in published reports.