Using mixed methods in health services research: A review of the literature and case study

Maarten de Haan*, Yvonne van Eijk-Hustings, Hubertus J. M. Vrijhoef

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Objective To provide an overview of the challenges of conducting mixed methods research (MMR) in the context of health services research (HSR) and to discuss a case study example of the triangulation procedures used in a MMR study on task-shifting in the Netherlands. Method A narrative literature review of publications between January 2000 and February 2020 on the use of mixed methods in the context of HSR and a description of the triangulation procedures in an HSR study with a MMR design on task shifting in the Netherlands. Results The narrative review identified eight challenges. Those related to publishing and appraisal of MMR within HSR were most frequently reported (e.g. 'lack of MMR examples', 'lack of recognition' and 'triangulation issues'). Also, practical problems for conducting MMR within HSR were identified (e.g. 'lack or resources', 'teamwork' and 'lack of quality criteria'). Methodological challenges (e.g. 'sampling' and 'paradigm wars') were less frequently reported as a challenge. Conclusion While increasing in popularity, there remain a range of challenges for the design, conduct and reporting of MMR designs in HSR. Using a triangulation protocol can potentially help address some of these challenges.

Original languageEnglish
Article number1355819620955223
Pages (from-to)141-147
Number of pages7
JournalJournal of Health Services Research & Policy
Issue number2
Early online date21 Sept 2020
Publication statusPublished - Apr 2021


  • health services research
  • mixed methods
  • triangulation


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