OBJECTIVES: To investigate (1) what type of knowledge production characterizes health services research - academically based (mode 1) or socially distributed (mode 2); (2) how leaders in health services research link to users of the research; (3) how this research is influenced by its funding base; and (4) the development and dissemination strategies of investigators. METHODS: Four purposively selected case studies of contrasting health services research groups generated early propositions (70 interviews). These led to a postal survey of key stakeholder groups in one English National Health Service region (199 responses, 53% response rate). RESULTS: Health services research in the UK is characterized by: a mix of mode 1 and mode 2 output indicators; strong external relationship building by group leaders; a powerful driver from external finance; and extensive dissemination and development activity. CONCLUSIONS: Health services researchers may have to operate in both modes. Mode 1 retains considerable defensive power, so there are limits to the extent to which mode 2 research may develop.
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