WILLIAM A. FLEXNER, DrPH ERIC N. BERKOWITZ, PhD
SERVICES HAVE BEEN DEFINED as "all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health" (1). Decisions about the design and delivery of services by private clinics, hospitals, neighborhood health centers, and health maintenance organizations (HMOs) are made primarily by professionals. Yet consumer input into these decisions is increasingly being sought, even demanded. Generally this input has been obtained by four methods: (a) consumer representation on boards, (b) consumer advocacy (for example, Ralph Nader's Health Research Group), (c) a diagnosis of the community (the community being regarded as the patient) and assessment of the community's needs, and (d) behavioral and social science research (2). These four methods provide for firsthand contact between health professionals and the lay public and a medically objective review of health care requirements. Yet, in application, weaknesses in the methods may be revealed, such as presumed representation of the whole consumer population, a tendency toward professional domination of decisions, and ineffective integration of consumer input into the organization's planning. These weaknesses often preclude the creation of programs and services that are sensitive and responsive to all sectors of the population (3).
HEALTH
The strengths of the four methods must be integrated into a managerial structure in order to produce programs and services that are satisfactory to health care consumers. To accomplish such integration, a framework is needed, and marketing research can provide it. Marketing research is the organizational activity of systematically gathering, recording, and analyzing the information needed to make planning and implementation decisions that affect the quality or intensity of an organization's interactions with consumers (4,5).