Research methodology: choices, logistics, and challenges.

Many complex issues are central to the ongoing debate about health care and health care delivery system reform in the United States (US) and worldwide. Academic medical centers, vulnerable populations, rural health, and hospitals represent but a few aspects of the fragmentation of the current health care delivery system. Although research offers considerable potential for generating insights into these issues, the challenge of developing and applying effective research methodology to study integrated health care delivery systems raises complex issues. In recent years, the roles, benefits, and challenges to appropriate use of research methods in the basic and applied social and clinical sciences have been debated extensively. These debates continue today.