Journal of Health Services Research & Policy

Journal of Health Services Research & Policy

2015 Impact Factor: 1.786
2015 Ranking: 31/75 in Health Policy & Services
2016 Release of Journal Citation Reports, Source: 2015 Web of Science Data

Jacqueline Cumming Professor of Health Policy and Management, and Director, Health Services Research Centre, Faculty of Health, Victoria University of Wellington, New Zealand
Ellen Nolte Honorary Professor, London School of Hygiene & Tropical Medicine ; Hub Coordinator, European Observatory on Health Systems and Policies

eISSN: 17581060 | ISSN: 13558196 | Current volume: 22 | Current issue: 2 Frequency: Quarterly
With ever increasing pressure for health services in all countries to meet rising demands, improve their quality and efficiency, and to be more accountable; the need for rigorous research and policy analysis has never been greater. The Journal of Health Services Research & Policy presents the latest scientific research, insightful overviews and reflections on underlying issues, and innovative, thought provoking contributions from leading academics and policy-makers. It provides ideas and hope for solving dilemmas that confront all countries.

The journal is always interested in discussing proposals for funded supplements. Estimated costs including peer review, editing of papers, and 100 sponsor copies is around £16,000 for a 64-page supplement, published in hardcopy as well as online (for subscribers). Interested parties should contact

This journal is a member of the Committee on Publication Ethics (COPE)

Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal's strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.

Editorial Committee Members
Yvonne Birks Social Policy Research Unit, University of York, UK
Maria Goddard Centre for Health Economics, University of York, UK
Scott Greer University of Michigan School of Public Health, USA
Steven Lewis Access Consulting Ltd, Canada
Catherine Pope University of Southampton, UK
Christine Rivett-Carnac Dept of Health Services Research & Policy, LSHTM, UK
Trevor Sheldon University of York, UK
Francesco Taroni University of Bologna, Italy
Justin Waring Nottingham University Business School, UK
Editorial Advisory Board
Davina Allen School of Healthcare Sciences, Cardiff University, UK
Nick Black UK
Jeffery Braithwaite Centre for Healthcare Resilience and Implementation Science, Macquarie University, Australia
Reinhard Busse Department of Health Care Management, Berlin Technical University, Germany
Mavis Cao Department of Health Policy and Management, Renmin University of China, China
Bronwyn Croxson Wellington, New Zealand
Nigel Edwards The Nuffield Trust, London, UK
Giovanni Fattore Centre for Research on Healthcare Management, Bocconi University, Italy
Josep Figueras European Observatory on Health Systems & Policies, WHO European Centre for Health Policy, Belgium
Colleen Flood Faculty of Law, University of Toronto, Canda
Claire Goodman Centre for Research in Primary and Community Care, University of Hertfordshire, UK
Peter Groenewegen NIVEL, Netherlands
Jane Hall Centre for Health Economics Research & Evaluation, University of Technology Sydney, Australia
Chris Ham The King's Fund, UK
Karen Hassell College of Pharmacy, California Northstate University, USA
Jan Kees Helderman Department of Public Administration & Political Science, Radboud University, Netherlands
Lisa Lezzoni Mongan Institute for Health Policy, Massachusetts General Hospital, USA
Kyoko Imamura Office of Pharmaceutical Medicine, Japan
Miriam Laugesen Department of Health Policy and Management, Columbia University Mailman School of Public Health, USA
John Lavis McMaster Health Forum, McMaster University, Canada
Yee Wei Lim Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Jill Manthorpe Kings College London, UK
Nicholas Mays London School of Hygiene & Tropical Medicine, UK
Ruth McDonald Manchester Business School, University of Manchester, UK
John McKinlay New England Research Institute, USA
Jon Nicholl School of Health & Related Research, University of Sheffield, UK
Kieke Okma Wagner School of Public Services, New York University, USA
Jan Abel Olsen Department of Community Medicine, University of Tromsø, Norway
David Pencheon NHS Sustainable Development Unit, UK
Neil Söderlund Boston Consulting Group, Australia
Paul Taylor Centre for Health Informatics & Multiprofessional Education, UCL, UK
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    1. Draft papers and abstracts
    2. Peer review policy
    3. Article types
    4. Authorship
    5. How to submit your manuscript
      5.1 Social Media - Twitter
    6. Journal contributor's publishing agreement
      6.1 SAGE Choice and Open Access
    7. Statements and conventions
      7.1 Acknowledgments
      7.2 Declaration of conflicting interests
      7.3 Funding acknowledgement
      7.4 Other statements and conventions
    8. Permissions
    9. Manuscript style
      9.1 File types
      9.2 Journal style
      9.3 Reference style
      9.4 Manuscript preparation
      9.5 ‘Perspectives’ Section Guidelines
      9.6 ‘Worth a second look’ Section Guidelines
      9.7 ‘Climate Change and Health Services’ Section Guidelines
      9.8 Statistics’ Guidelines
    10. After acceptance
      10.1 Proofs
      10.2 E-Prints
      10.3 SAGE production
      10.4 OnlineFirst publication
    11. Further information

    The Journal of Health Services Research and Policy (JHSRP) publishes scientific research on health services from a wide variety of disciplines and rigorous health care policy analysis. The Journal also engages in, and responds to, current scientific, methodological and policy debates in health care. The Journal aims both to reflect current concerns and to contribute to setting the agenda.

    1. Draft papers and abstracts

    Only manuscripts submitted online in accordance with the guidelines below will be considered for publication. The editorial office will not provide individual advice or feedback on draft papers or abstracts before submission.

    Please submit your paper through our journal website ( to ensure rapid consideration - we operate a fast response system whereby the editors decide within 3-4 weeks whether to send the paper for peer review, or reject at the first stage because of lack of suitability. Note that papers which do not adhere to word and reference limits and are not in the correct format are likely to be rejected outright.

    As we are a multidisciplinary journal, and there are 3 main criteria we look out for:
    • the importance and originality of the research/policy question;
    • the extent to which the implications of the findings for policy or practice have been drawn out and have been justified;
    • and the degree to which the paper would be understood by an international audience which is not necessarily familiar with the health system in question - the paper needs to avoid being parochial and focus on the underlying issue of international interest.

    2. Peer review policy

    All papers submitted for publication undergo peer review.

    All Original Research, Essays and Review articles are initially reviewed by one or both Editors who select two appropriate reviewers unless the manuscript is of poor quality, outside the scope of the Journal, or not considered sufficiently original or important given the space constraints of a quarterly journal, in which case it is rejected without peer review. Generally, we choose one reviewer who can comment primarily on the methodological aspects of the paper and one who can primarily assess its policy relevance and implications. We invite authors to suggest two reviewers, one of whom we may use. Most of our reviewers are based in Europe, North America or Australia/New Zealand and are suggested to us by members of the Advisory Board and other established researchers in the field.

    For ethical reasons, attempts are made to mask reviewers to the identity of the authors by excluding the names and affiliations of authors and acknowledgements from the manuscript. Our aim is to make initial decisions on manuscripts within 12 weeks of receiving them.

    The contents of the manuscript should be treated as confidential and should not be discussed with anyone else without prior permission from the editors. Reviewers are asked to comment on the following issues:

    1. Importance of the research/policy question
    2. Originality of the research/policy question
    3. Strengths and weaknesses either of the study design, data collection and data analysis (for research papers) or the policy analysis/commentary (for policy papers)
    4. The writing, organisation and presentation of the data in the paper
    5. The extent to which the implications of the findings have been drawn out and have been justified
    6. The degree to which the paper would be understood by an international audience which is not necessarily familiar with the health system in question (not applicable for systematic reviews)

    Reviewers are not asked explicitly to give their opinion as to whether or not the paper should be published.

    The Editors aim to decide on each paper within 4-6 weeks of receipt of the second review. Three decisions are available: accept; resubmit; and reject. Authors are sent the editorial decision together with copies of the two reviewers' comments (anonymised). The Editors usually send individualised feedback letters to authors, if the authors are being invited to resubmit the paper. Reviewers are sent the other reviewer's anonymised comments for information.

    Covering letter
    The covering letter is important. To help the Editors in their preliminary evaluation, please indicate why you think the paper suitable for publication.

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    3. Article types

    Please note that all word counts include the abstract, main text and references. Please do not exceed the word limit.

    Quantitative empirical research
    Papers could be up to 3000 words inclusive of abstract, main text, and up to 30 references, plus up to six figures, and/or tables and boxes

    Qualitative and mixed methods
    Papers can be up to 5000 words inclusive of abstract, main text and up to 30 references, plus up to two figures, and/or tables and boxes

    Essays (i.e. commentaries and theoretical pieces) 
    Essays can be up to 4000 words inclusive of abstract, main text and up to 30 references

    Systematic reviews 
    Reviews can be up to 5000 words inclusive of abstract, main text and up to and 50 references

    These should be 800-1200 words including up to 12 references

    Perspective articles 
    These require an unstructured abstract and can be up to 2000 words including up to 30 references. Please consult section 8.8 for more details.

    Worth a Second Look articles
    Articles can be up to 1500 words including up to 12 references. Please consult section 8.6 for more details.

    8.7 Climate Change and Health Services articles
    These contributions can be original research articles, reviews, essays or editorials. Please consult section 8.7 for more details.

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    4. Authorship

    Papers should only be submitted for consideration once the authorization of all contributing authors has been gathered. Those submitting papers should carefully check that all those whose work contributed to the paper are acknowledged as contributing authors.

    The list of authors should include all those who can legitimately claim authorship. This is all those who:

    1. have made a substantial contribution to the concept and design, acquisition of data or analysis and interpretation of data
    2. drafted the article or revised it critically for important intellectual content
    3. approved the version to be published.

    Authors should meet the conditions of all of the points above. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content.

    When a large, multicentre group has conducted the work, the group should identify the individuals who accept direct responsibility for the manuscript. These individuals should fully meet the criteria for authorship.

    Acquisition of funding, collection of data, or general supervision of the research group alone does not constitute authorship, although all contributors who do not meet the criteria for authorship should be listed in the Acknowledgments section.
    Please refer to the ICMJE Authorship guidelines at

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    5. How to submit your manuscript

    Before submitting your manuscript, please ensure you carefully read and adhere to all the guidelines and instructions to authors provided below. Manuscripts not conforming to these guidelines may be returned.

    Only manuscripts submitted via the online manuscript submission and peer review site, which can be found at will be considered for publication.

    All submissions must be in English. Text should be double-spaced with a minimum of 3cm margins. Text should be standard 10 or 12 point.

    To allow for blinded peer review, details of authorship (for each author: one qualification, job title, appointment at the time of the research, current address and email address) and acknowledgements must not be included in the main manuscript, but must be supplied separately.

    When submitting a manuscript, the title page, main text, tables or boxes, figures and acknowledgements must be saved and uploaded as separate files:

    • Title page file – Manuscript title, Author(s)’ name; author’s position, department, institution and country; Name, email, telephone and fax of corresponding author
    • Main text file – Manuscript title, Abstract, Main Text and References (minus author details, acknowledgements and any running heads of author names, to allow blinded review)
    • Keywords (approximately 3 keywords)
    • Tables [or Boxes] – separate file(s)
    • Figures – separate file(s)
    • Appendix – separate file(s)
    • Acknowledgements – separate file
    • Supplementary file – supplementary material can be added.

    5.1 Social Media - Twitter

    JHSRP uses the social media hashtag of #jhsrp. Authors and readers are encouraged to join the ongoing discussion around the hashtag on issues related to the journal. JHSRP authors are offered the option of providing their twitter handle to be published alongside their name and email address within their article. Providing a twitter handle for publication is entirely optional, if you are not comfortable with JSHRP promoting your article along with your personal twitter handle then please do not supply it. 

    By providing your personal twitter handle you agree to let JHSRP and SAGE Publications to use it in any posts related to your journal article. To include your twitter handle within your article please provide this within the ScholarOne submission form when prompted and on the separate title page in the format outlined below (please refrain from adding it to the manuscript itself to faciliate anonymous peer review).

    As an example of how to supply this information please use the example below: 

    Dr. Joe Bloggs, Department of Research, University, Town, ZipCode, USA
    Twitter: @drjoebloggs

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    6. Journal contributor’s publishing agreement   

    Before publication SAGE requires the author as the rights holder to sign a Journal Contributor’s Publishing Agreement. SAGE’s Journal Contributor’s Publishing Agreement is an exclusive licence agreement which means that the author retains copyright in the work but grants SAGE the sole and exclusive right and licence to publish for the full legal term of copyright.  Exceptions may exist where an assignment of copyright is required or preferred by a proprietor other than SAGE. In this case copyright in the work will be assigned from the author to the society. For more information please visit our Frequently Asked Questions on the SAGE Journal Author Gateway.

    Furthermore papers submitted should not have been published and should not currently be under consideration for publication elsewhere. Please read JHSRP's policy statement clarifying what constitutes prior publication.

    Journal of Health Services Research and Policy and SAGE take issues of copyright infringement, plagiarism or other breaches of best practice in publication very seriously. We seek to protect the rights of our authors and we always investigate claims of plagiarism or misuse of published articles. Equally, we seek to protect the reputation of the journal against malpractice. Submitted articles may be checked with duplication-checking software. Where an article, for example, is found to have plagiarised other work or included third-party copyright material without permission or with insufficient acknowledgement, or where the authorship of the article is contested, we reserve the right to take action including, but not limited to: publishing an erratum or corrigendum (correction); retracting the article; taking up the matter with the head of department or dean of the author's institution and/or relevant academic bodies or societies; or taking appropriate legal action.

    6.1 SAGE Choice and Open Access

    If you or your funder wish your article to be freely available online to non subscribers immediately upon publication (gold open access), you can opt for it to be included in SAGE Choice, subject to payment of a publication fee. The manuscript submission and peer review procedure is unchanged. On acceptance of your article, you will be asked to let SAGE know directly if you are choosing SAGE Choice. To check journal eligibility and the publication fee, please visit SAGE Choice. For more information on open access options and compliance at SAGE, including self author archiving deposits (green open access) visit SAGE Publishing Policies on our Journal Author Gateway.

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    7. Statements and conventions

    7.1. Acknowledgements

    Any acknowledgements should appear first at the end of your article prior to your Declaration of Conflicting Interests (if applicable), any notes and your References.

    All contributors who do not meet the criteria for authorship should be listed in an ‘Acknowledgements’ section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Authors should disclose whether they had any writing assistance and identify the entity that paid for this assistance.

    7.2 Declaration of conflicting interests

    Within your Journal Contributor’s Publishing Agreement you will be required to make a certification with respect to a declaration of conflicting interests. It is the policy of Journal of Health Services Research and Policy to require a declaration of conflicting interests from all authors enabling a statement to be carried within the paginated pages of all published articles.

    Please include any declaration at the end of your manuscript after any acknowledgements and prior to the references, under a heading ‘Declaration of Conflicting Interests’. If no declaration is made the following will be printed under this heading in your article: ‘None Declared’. Alternatively, you may wish to state that ‘The Author(s) declare(s) that there is no conflict of interest’. 

    When making a declaration the disclosure information must be specific and include any financial relationship that all authors of the article has with any sponsoring organization and the for-profit interests the organization represents, and with any for-profit product discussed or implied in the text of the article.

    Any commercial or financial involvements that might represent an appearance of a conflict of interest need to be additionally disclosed in the covering letter accompanying your article to assist the Editor in evaluating whether sufficient disclosure has been made within the Declaration of Conflicting Interests provided in the article.

    For more information please visit the SAGE Journal Author Gateway.

    7.3 Funding Acknowledgement

    To comply with the guidance for Research Funders, Authors and Publishers issued by the Research Information Network (RIN), Journal of Health Services Research and Policy additionally requires all Authors to acknowledge their funding in a consistent fashion under a separate heading.  Please visit Funding Acknowledgements on the SAGE Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding or state in your acknowledgments that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 

    7.4 Other statements and conventions

    7.4.1 Research ethics
    All papers reporting animal and human studies must include whether written consent was obtained from the local Ethics Committee or Institutional Review Board. Please ensure that you have provided the full name and institution of the review committee and an Ethics Committee reference number.

    We accept manuscripts that report human and/or animal studies for publication only if it is made clear that investigations were carried out to a high ethical standard. Studies in humans which might be interpreted as experimental (e.g. controlled trials) should conform to the Declaration of Helsinki and typescripts must include a statement that the research protocol was approved by the appropriate ethical committee. In line with the Declaration of Helsinki 1975, revised Hong Kong 1989, we encourage authors to register their clinical trials (at or other suitable databases identified by the ICMJE, If your trial has been registered, please state this on the Title Page. When reporting experiments on animals, indicate on the Title Page which guideline/law on the care and use of laboratory animals was followed.

    7.4.2 Patient consent
    Authors are required to ensure the following guidelines are followed, as recommended by the International Committee of Medical Journal Editors, Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Patients have a right to privacy that should not be infringed without informed consent. Identifying information, including patients' names, initials, or hospital numbers, should not be published in written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication. Informed consent for this purpose requires that a patient who is identifiable be shown the manuscript to be published.

    Identifying details should be omitted if they are not essential. Complete anonymity is difficult to achieve, however, and informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of patients is inadequate protection of anonymity. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance that alterations do not distort scientific meaning and editors should so note. When informed consent has been obtained it should be indicated in the submitted article.

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    8. Permissions

    Authors are responsible for obtaining permission from copyright holders for reproducing any illustrations, tables, figures or lengthy quotations previously published elsewhere. For further information including guidance on fair dealing for criticism and review, please visit our Frequently Asked Questions on the SAGE Journal Author Gateway.

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    9. Manuscript style

    9.1 File types

    Text files must be saved in .doc or .rtf format. Other suitable formats include .tif for photographic images, .xls for graphs produced in Excel, and .eps for other line drawings.

    9.2 Journal Style

    Title page
    The first page should contain the full title of the manuscript, 3 keywords, the author(s) name(s) and affiliation(s), and the name, postal and email addresses of the author for correspondence, as well as a full list of declarations.

    The title should be concise and informative, accurately indicating the content of the article.

    Original research and Review articles should include a structured abstract (objectives, methods, results, conclusions). Essays and Perspectives should include an unstructured abstract.

    Tables and Boxes
    Tables and Boxes should be outwith the text. Tables must be prepared using the Table feature of the word processor. Tables should not duplicate information given in the text, should be numbered in the order in which they are mentioned in the text, and should be given a brief title.

    Figures should be outwith the text. All figures should be numbered in the order in which they are mentioned in the text. All figures must be accompanied by a figure legend. If figures are supplied in separate files, the figure legends must all be listed at the end of the main text file.

    Line drawings should be produced electronically and clearly labelled using a sans serif font such as Arial. Graphs may be supplied as Excel spreadsheets (one per sheet). Other line drawings should be supplied in a suitable vector graphic file format (e.g. .eps)

    All photographic images should be submitted in camera-ready form (i.e. with all extraneous areas removed), and where necessary, magnification should be shown using a scale marker. Photographic images must be supplied at high resolution, preferably 600 dpi. Images supplied at less than 300 dpi are unsuitable for print and will delay publication. The preferred file format is .tif.

    Symbols and abbreviations should be those currently in use. Authors should not create new abbreviations and acronyms. The RSM’s book Units, Symbols and Abbreviations provides lists of approved abbreviations.

    All measurements should be expressed in SI units.

    If preparing statistical data for publication, please read the statistical guidelines (section 8.8).

    9.3 Reference Style

    Only essential references should be included. Authors are responsible for verifying them against the original source material. SAGE uses the Vancouver referencing system ( references should be identified in the text by superscript Arabic numerals after any punctuation, and numbered and listed at the end of the paper in the order in which they are first cited in the text. Automatic numbering should be avoided. References should include the names and initials of up to three authors. If there are more than three authors, only the first three should be named, followed by et al. Publications for which no author is apparent may be attributed to the organization from which they originate. Simply omit the name of the author for anonymous journal articles – avoid using ’Anonymous’. Punctuation in references should be kept to a minimum, as shown in the following examples:

    1. Handy CB. Understanding organisations. 3rd edn. London: Penguin, 1985
    2. Hart E. Ghost in the machine. Health Serv J 1991;101:20–1

    9.4 Manuscript Preparation

    The text should be double-spaced throughout and with a minimum of 3cm for left and right hand margins and 5cm at head and foot. Text should be standard 10 or 12 point.

    9.4.1 Your Title, Keywords and Abstracts: Helping readers find your article online

    The title, keywords and abstract are key to ensuring readers find your article online through online search engines such as Google. Please refer to the information and guidance on how best to title your article, write your abstract and select your keywords by visiting SAGE’s Journal Author Gateway Guidelines on How to Help Readers Find Your Article Online.

    9.4.2 Corresponding Author Contact details

    Provide full contact details for the corresponding author including email, mailing address and telephone numbers. Academic affiliations are required for all co-authors. These details should be presented separately to the main text of the article to facilitate anonymous peer review.

    9.4.3 Guidelines for submitting artwork, figures and other graphics

    For guidance on the preparation of illustrations, pictures and graphs in electronic format, please visit SAGE’s Manuscript Submission Guidelines.

    Figures supplied in colour will appear in colour online regardless of whether or not these illustrations are reproduced in colour in the printed version. For specifically requested colour reproduction in print, you will receive information regarding the costs from SAGE after receipt of your accepted article.

    9.4.4 Guidelines for submitting supplemental files

    This journal is able to host approved supplemental materials online, alongside the full-text of articles. Supplemental files will be subjected to peer-review alongside the article.  For more information please refer to SAGE’s Guidelines for Authors on Supplemental Files.

    9.4.5 English Language Editing services

    Non-English speaking authors who would like to refine their use of language in their manuscripts might consider using a professional editing service.  Visit English Language Editing Services on our Journal Author Gateway for further information.

    9.5 ‘Perspectives’ Section Guidelines

    These require an unstructured abstract and can be up to 2000 words inclusive of abstract, main text and up to 30 references.

    9.5.1 The ‘Perspective' section of the Journal of Health Services Research and Policy (JHSRP) is a short essay, of around 2000 words (and up to 30 references), reviewing either a single, fundamental concept in current use in the arena, or a cluster of related concepts.

    9.5.2 The aim of JHSRP is to raise the level of academic and policy debate. The 'Perspective' section contributes towards this, by offering brief, provocative but scholarly reviews of some of the prevalent ideas used in analysis and policy discourse.

    9.5.3 The problem which it tackles is this: all academics and policy-makers live in a world of sedimented jargon; a rich morass of concepts, slogans and clichés: a few we can define precisely, many we can only vaguely remember, most we have never properly learned but have picked up from seminars, odd bits of reading and from conversation in bars. In a multidisciplinary area, such as health services research and health policy, where each of us must sometimes draw on several different disciplines, our individual understanding of the conceptual stew can be even more tenuous. This difficulty is made even greater by the considerable distance at which all of us operate from our home base. Medical statisticians get cut off from statistics, public health doctors lose contact with clinical medicine and epidemiology, social scientists can become remote from a good deal of the work of their parent disciplines.

    9.5.4 We need, therefore, to improve our conceptual grasp, both of our own particular area and of the more general health policy arena in which we work. To this end, 'Perspective' recruits leading scholars to produce concise, readable, wide-ranging and informative reviews of some of the basic concepts in the field.

    9.5.5 In reviewing a concept, authors might consider:

    • its historical origins;
    • how it has developed over time;
    • whether or not there is any evidence for it;
    • the current state of research and theory;
    • what further research may need to be done;
    • how far it might be used to analyse other areas;
    • how far it has been taken up by outsiders;
    • how far it has been properly understood;
    • how far its policy implications have been realised;
    • what its policy results, good or bad, may have been;
    • the particular interests to which it has appealed;
    • the ideological distortions it may have undergone;
    • the different meanings and usages it has acquired;
    • other concepts which are closely related;
    • whether there are better ideas which have been ignored;
    • the underlying disciplinary ideas on which it is based;
    • whether, in fact, there is a disciplinary base for it;
    • what its popularity demonstrates about its users;
    • how far the idea is demand-driven, rather than research-led.

    9.5.6 We have chosen an essay format to allow our contributors as much flexibility as possible. Each ‘Perspective’ piece will, obviously, be a personal view. However, it is important that the view is not too narrowly focused and that several of the core topics in the list above are touched upon. In particular, the origins, scientific adequacy, popularity and policy implications of the idea should all be considered, though contributors are free to vary the balance between these.

    9.5.7 The concept chosen for analysis can be an old idea that is mostly taken for granted, or a new phrase or idea that has become widely fashionable. In either case, what is important is that the underlying disciplinary roots of the idea are exposed. New terms that sweep across the arena commonly rest on old ideas from particular disciplines. The aim of the section is to consider the academic base, not simply to compile lists of contemporary jargon or poke fun at the latest cliché.

    9.5.8 ‘Perspectives’ pieces can either be destructive or constructive. Constructive pieces are generally preferred, but sometimes a wholly destructive piece is just what is needed. Likewise, although ‘Perspectives’ pieces must always be scholarly, there is room, on occasion, for polemic as well as for judicious review. Each ‘Perspective’ will be written in language intelligible to those outside the writer's own discipline.

    9.6 ‘Worth a second look’ Section Guidelines
    Articles can be up to 1500 words inclusive of main text and up to 12 references.

    The objective of 'Worth a second look' is for the author to discuss a paper or book or report which has particularly caught his/her attention and which either might not necessarily have been identified by many of the readers of the journal or has been forgotten. We are particularly interested in using the section to draw attention to papers published in journals outside the mainstream of health services research (e.g. in clinical journals or in disciplinary journals in the social sciences which are not normally looked at by many health researchers), but which might, nonetheless, be relevant and illuminating for our readers. The choice of either methodological or substantive papers/books is entirely up to the author of 'Worth a second look'. Contributors should try and convey to the reader why their chosen paper/book excited them.

    9.7 ‘Climate Change and Health Services’ Section Guidelines
    These contributions can be original research articles, reviews, essays or editorials.

    The Journal of Health Services Research & Policy currentlywishes to provide a platform to reflect critically and analytically on the challenges for health services brought about by climate change.

    Contributions should explore the impact of climate change on health services and the ways in

    which health systems can prepare for the challenges brought about by climate change.

    We welcome contributions that offer original insights, critical perspectives or present new

    research addressing such themes as:

    • What changes can be implemented to achieve a ‘greener’ health system?
    • How can we reduce the environmental impact of health services?
    • What will the financial burden to the health sector imposed by climate change mean for
    • Health services delivery?
    • What policies can we design to reduce the health inequalities brought about by different
    • Regional patterns of climate change?
    • What are the key changes in service delivery that are necessary to ensure health care
    • will be sustainable when faced with extreme weather and changes in disease incidence
    • Resulting from climate change?

    9.8 Statistics’ Guidelines

    These guidelines are designed to help authors prepare statistical data for publication and are not a substitute for the detailed guidance required to design a study or perform a statistical analysis. Each section of a scientific paper is addressed separately.

    The number and source of data must be stated and conclusions which have a statistical basis must be substantiated by inclusion of pertinent descriptive statistics (mean or median, standard deviation [SD] or interquartile range, percentage coefficient of variation [%CV], 95% confidence limits, regression equations, etc.).

    Experimental design, subject selection and randomization procedures should be described and analytical precision quoted when appropriate. The hypotheses to be tested by a statistical procedure must be stated and where appropriate power calculations for the sample size used should be given (it is recommended that the power is X80%). In case-control studies clearly define how cases and controls were selected and what matching has taken place.
    We would advise authors to consider the STARD,1 CONSORT2 and STROBE3 statements for studies reporting diagnostic or clinical trials. They offer guidance on writing reports with complete clarity.

    Unnecessary precision, particularly in tables, should be avoided. Rounded figures are easier to compare and extra decimal places are rarely important. Descriptive statistics require an additional digit to those used for the raw data. Percentages should not be expressed to more than one decimal place and not be used at all for small samples.
    Normally distributed data should be described using a mean, SD and/or %CV and expressed as ‘mean (SD)’ not ‘mean ± SD’. When data are not normally distributed, following demonstration by tests such as the Shapiro-Wilk test,4 then medians and interquartile ranges should be used in place of mean and SD. Skewed data can often be normalized by logarithmic transformation or a power transformation. The statistical analysis and calculation of summary statistics should be carried out on the transformed data and the summary statistics transformed back to the original scale for presentation. If a logarithmic scale is used then graphs should display non-transformed data on a logarithmic scale.
    Graphs showing data of comparable magnitude should be of a similar size and design. All individual points should be displayed where possible by displacing overlapping points. Error bars showing the standard error of the mean (SEM) or interquartile range, as appropriate, can be used to aid interpretation of the data.
    The results of significance tests such as Student’s and chi-squared should be presented with descriptive statistics, degrees of freedom (if appropriate) and probability P. The validity of any assumptions should be checked (e.g. conventional t-tests assume a normal distribution and equal variance for each set of data). For 2 x 2 contingency table analysis by the chi-squared test the continuity correction must be applied and for small expected frequencies Fisher’s Exact Test used. P values should be reported in fullto1or 2 significant figures, describing P values as 40.05 or NS (not significant) should be avoided. If the results are highly significant and the calculated P value from the computer is e.g. 0.000, then the use of P <_0.0005 is="is" acceptable.="acceptable." confidence="confidence" intervals="intervals" should="should" be="be" stated="stated" particularly="particularly" for="for" non-significant="non-significant" results.="results." br="br">The conventional use of statistical significance is P≤0.05. If a different significance level needs to be used then the reasons why must be clearly stated in the statistical method section.

    Statistical significance should not be equated to importance and P values should not be compared between different data sets or different statistical tests. Association should not be interpreted as causation without additional evidence.

    Problem areas:

    Multiple comparisons

    Multiple comparisons can produce spurious and misleading significance values. The primary hypothesis should always be clearly stated, and associations detected by retrospective analysis should be interpreted with caution. Whenever possible a single overall statistical test should be applied first e.g. ANOVA. If this is not significant then multiple comparisons must not be applied. If it is significant then some form of multiple range test can be applied. If a single overall test is not possible then multiple comparisons must use a Bonferroni type significance level.

    Paired data
    With paired data the differences between individual pairs of data and the variability of the differences are more important than the individual values. Graphical representation should also show the difference between individual pairs, e.g. by plotted lines joining the paired data points.

    Standard regression analysis
    Standard regression analysis requires data points to be independent (repeated measurements are not independent). The independent variable should be measured without significant error, e.g. age or time, and the points should be evenly distributed over the range and have no outliers (this can be easily examined with a scatterplot). These requirements are rarely satisfied with biological data.

    Method comparison
    Method comparison using regression and correlation coefficients is inappropriate and should be performed using Altman and Bland difference plots.5 If a standard scatter plot and regression line are thought to be useful they can be given along with the Altman–Bland plot. Remember if two methods are supposed to be measuring the same thing then it is extremely likely they will be correlated so as a statistical tool correlation is not going to tell you anything new.

    If you are carrying out complicated statistical analyses e.g. multivariate analysis, ROC analysis etc., then it is recommended that you seek advice from a statistician.

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    10. After acceptance           

    10.1 Proofs

    We will email a PDF of the proofs to the corresponding author. Authors must return their proof corrections in annotated PDF form where possible, or as an emailed list (specifying page numbers, etc.) within 5 working days.

    10.2 E-Prints

    SAGE provides authors with access to a PDF of their final article. For further information please visit Offprints and Reprints on our Journal Author Gateway.

    10.3 SAGE Production

    At SAGE we place an extremely strong emphasis on the highest production standards possible. We attach high importance to our quality service levels in copy-editing, typesetting, printing, and online publication ( We also seek to uphold excellent author relations throughout the publication process.

    We value your feedback to ensure we continue to improve our author service levels. On publication all corresponding authors will receive a brief survey questionnaire on your experience of publishing in Journal of Health Services Research and Policy with SAGE.

    10.4 OnlineFirst Publication

    A large number of journals benefit from OnlineFirst, a feature offered through SAGE’s electronic journal platform, SAGE Journals Online. It allows final revision articles (completed articles in queue for assignment to an upcoming issue) to be hosted online prior to their inclusion in a final print and online journal issue which significantly reduces the lead time between submission and publication. For more information please visit our OnlineFirst Fact Sheet.

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    11. Further information

    Any correspondence, queries or additional requests for information on the Manuscript Submission process should be sent to the Editorial Office as follows:

    Christine Rivett-Carnac
    Editorial Administrator, Journal of Health Services Research & Policy
    Department of Health Services Research & Policy
    London School Hygiene and Tropical Medicine,
    15-17 Tavistock Place, London WC1H 9SH, UK
    Tel: +44 (0)20 7927 2107,  Fax: +44 (0)20 7927 2701

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