>> Prof. Brücher, first a fundamental question for you as a doctor: How do you define health services research?
Thank you for the exciting question. In 1999, the German Research Foundation (DFG) defined health services research as one of three aspects, but it is still neglected politically.
Health services research includes research in the field of patient care (care, nursing, diagnosis and treatment as well as aftercare), health research (including prevention and health promotion) and nursing research. This means that health services research is interdisciplinary. This has recently led to the emergence of follow-up centers (intestinal centers, vascular centers, diabetes centers, cardiology centers, etc.).

Her specialty is surgery. What role has this discipline played in the history of health services research so far?
More than 100 years ago, Theodor Billroth called for the results of surgery to be transparently presented in order to improve patient treatment. This led to the development of clinical quality assurance in the 1970s, which forms the basis of clinical health services research. Here too, surgery was the driving force for further developments. Quality assurance was first taken up as a congress topic in 1977 by the surgeon Professor Wolfgang Schega, who came from Dresden and worked in Krefeld. The professors Ingo Gastinger and Hans Lippert, who work in East Germany, then took up this topic and revised the old WHO surgical catalog from 1953 in a Sisyphean task. The result today - with marginal changes - is a surgical catalog that is valid and used throughout Germany .

Would you describe these three doctors – Wolfgang Schega, Ingo Gastinger and Hans Lippert – as the forefathers of health services research?
Not just her. It must also be mentioned that the already mentioned catalogue, which was introduced with painstaking detailed work, was taken to Cologne during the fall of the German Institute for Medical Documentation and Information (DIMDI) and then introduced throughout Germany without naming the authors from the old GDR. The pioneers of that time were groundbreaking and should also be named in addition to the previous ones: Walter Asperger, Wolfgang Hartig, Hermann Herwig, Josef Horntrich, Andreas Koch, Winfried Mokros, Horst Rupprecht, Harald Schramm and Klaus Gellert.
The group around Professor Helmut Wolff, who was then working at the Berlin Charité, established this approach for the first time as a uniform, comprehensive system for recording surgical performance that encompasses the entire hospital profile and is therefore comparable.
The basis for this was, among other things, that at the beginning of the 20th century clinical research was not only reserved for universities and other research institutions, but that demanding scientific topics were also being worked on in city, district and private hospitals.
An increasing loss of scientific clinical work in these hospitals can now be observed. These small hospitals are also given little consideration in research programs. this leads to

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