Personnel Needs and Training for Biomedical and Behavioral Research 1985 Report (1985) / Chapter Skim
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5 Health Services Research
5 Health Services Research
Pages 105-122
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From page 105... ...
Research activities also are supported by professional societies and private business. Federal support of health services research has its principal focus in the National Center for Health Services Research and Health Care Technology Assessment, the Office of Research and Demonstrations of the Health Care Financing Administration, and the Veterans Administration.
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From page 106... ...
The past two years have witnessed rapid and profound changes such as the institution of prospective payments for hospital payments by Medicare, the rapid growth of for-profit health care, the adoption of business-oriented goals by many health care providers, and the limitation of Medicaid patients' choices of providers by some states. Major employers such as General Motors have drastically changed their employee health insurance benefits to encourage prudent use of health care resources.
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From page 107... ...
provides a range of services to a defined population for a fixed annual or monthly payment. This form of medical care delivery, in contrast to fee-for-service, contains financial incentives to perform fewer services and to emphasize health promotion and disease prevention.
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From page 108... ...
These findings suggest that self-selection has not markedly biased the results of earlier, nonexperimental studies and lend support to the group-practice model HMO as a lower-cost alternative to traditional methods of health care delivery. Health Status and Medical Care Utilization Expenditures for health care have grown enormously over the past 20 years.
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From page 109... ...
19~. Foundations such as the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the Hartford and Kellogg Foundations, continue to play an important role in the support of health services research.
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From page 110... ...
Major professional associations support health services research in several ways; they collect, process, and disseminate data on their members which then serves as a resource for research by their own research staff members and by academic investigators. Major examples are the American Medical Association's Physician Masterfile and the data on hospital characteristics maintained by the American Hospital Association.
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From page 111... ...
Priority areas for 1985 include: {1) Health promotion and disease prevention: health status measurement, organization, and provider studies, analysis of public and private program interventions, and methods to increase consumer knowledge and change health attitudes and behavior.
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From page 112... ...
The National Health Care Expenditures Study, using information from a large national survey, examines how Americans use and pay for health care services. The Health Status and Health Promotion Studies Program focuses on measuring the level of health and on evaluating strategies to modify behavioral practices that have an adverse impact on health status.
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From page 113... ...
Health Care Financing Administration (HCFA) As the agency responsible for managing Medicare, Medicaid, the End Stage Renal Disease Program, professional review, and their accompanying statistical and monitoring activities, HCFA, through its Office of Research and Demonstrations (ORD)
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From page 114... ...
National Institutes of Health While NIH does not separately identify grants for health services research, such research activity can be found in a number of institutes, primarily in comprehensive centers and control programs for cancer, diabetes, arthritis, and cardiovascular and pulmonary diseases (IOM, 19791. The NIH biennially compiles information on federal obligations for the conduct of health research and development
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From page 115... ...
analysis of the organization, delivery, and impact of health promotion and disease prevention activities; (b) analysis of the factors underlying the increase in health care costs and the structural reforms and incentives which might modify these; (c)
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From page 116... ...
The major focal points for health services research in the federal government are the National Center for Health Services Research and the Office of Research and Demonstrations of the Health Care Financing Administration. The Veterans Administration also conducts a small health services research program.
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From page 117... ...
THE MARKET OUTLOOK FOR HEALTH SERVICES RESEARCH PERSONNEL Data are not available that would allow the committee to make quantitative estimates of the current supply of health services research personnel, nor that would support projections of future
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From page 118... ...
, private foundations that have provided significant support for the field, academic and non-academic employers of health services researchers including health services research centers, the Association for Health Services Research, and other relevant professional organizations. The research agenda can draw upon the past work of this committee's health services research panel, which gave considerable thought to the merits of various approaches for improving the information base in health services research.
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From page 119... ...
TABLE 5.5 Characteristics of Health Services Research Centers, 1983 Number of Centers Number of Full-Time Employees Budgeta Organizational Location Office of the President, Chancellor, or Vice President Graduate School of Business, Management, Public Administration, Social Welfare School of Medicine School of Public Health Other Sources of Funding Federal Government State/Local Government Private Foundation Corporation Parent University Endowment Income Other Training Capability None Internships Predoctoral fellows Postdoctoral fellows Other a Based on 36 centers reporting. 38 3-71 $120,00~$5.5 million 6 5 9 8 10 28 12 27 18 16 6 3 12 9 13 15 SOURCE: Association for Health Services Research (1983)
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From page 120... ...
Part of a research agenda on health services research personnel should be an assessment of the appropriateness of training. lathe committee listed as examples anthropology, sociology, psychology, economics, political science, biomedical and clinical sciences, public health, epidemiology, biostatistics, operations research, health administration, health education and public administration.
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From page 121... ...
The field's importance is even greater in this time of rapid and profound changes in the organization and financing of health care and the proliferation of medical technology. To maintain an adequate pool of qualified investigators to address questions of the quality, cost, and effectiveness of health care in the future, the committee recommends that NRSA awards be made specifically and explicitly for health services research training at levels of support set out in Chapter 1.
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From page 122... ...
TABLE 5.7 Field of Highest Degree Reported by NCHSR Trainees, FY 1978 Field of Highest Degree TOTAL Total Behavioral Sciences Anthropology Psychology Sociology Total Social Sciences Economics/Econometrics Political Science Other Total Biomedical Sciences Biometrics/Biostatistics Other Total Medical Sciences Public Health and Epidemiology Nursing Other Total Other Fields Bioengineering Operations Research Public Administration Other a Excludes full-time degree candidates. SOURCE: National Research Council (1977a)
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