TABLE 8-4 NIH Institute Health Services Research Budgets Health Services Research FY 2008 Estimate (Dollars in Thousands)

 

Total Health Services Research Budget

Proportion of Total Institute Budget That Is Health Services Research

Proportion of NIH’s Total Health Services Research Budget

NIMH

$94,273

6.67%

12.68%

NIDA

$61,207

6.08%

8.23%

NCI

$207,363

4.29%

27.89%

NIA

$47,696

4.53%

6.42%

NIDDK

$28,944

1.55%

3.89%

NIAAA

$22,410

5.10%

3.01%

NHLBI

$55,968

1.90%

7.53%

NINR

$21,227

15.38%

2.86%

Other NIH HSR

$204,298

1.28%

27.48%

Total

$743,388

 

 

SOURCE: Coalition for Health Services Research (2008). Analysis was completed using data from NIH’s Research Portfolion Online Reporting Tools (RePORT).

Other private-sector health services research careers are in research organizations sponsored by HMOs and health plans, hospital systems, pharmaceutical firms, insurers, and other major stakeholders in health care. Health services research positions may involve directing research, translating research into practice and products, and managing and evaluating health care operations.

Associations for professional groups, manufacturers, and advocacy groups recruit people trained in health services research to strengthen their capacity to use information com-ing from health services research to advance their advocacy objectives and meet the needs of their members. As efforts to translate science into practice accelerate, the demand for individuals skilled in health services research and communication to users is likely to grow.

Government agencies recruit substantial numbers of health services research professionals to lead and manage research programs, to support policy analysis and development, and to work with managers and providers in the VA and DoD health care delivery systems.

New career paths for health services research professionals may emerge as research into effective translation of knowledge into practice grows. The 2003 Medicare prescription drug legislation mandated in Section 1013 that comparative effectiveness studies of health care services including prescription drugs increased the need for health services researchers trained in pharmaco-economics. The ARRA provided a substantial increase in CER funding for both research and investment in research infrastructure including methods and data. The development of tools and techniques to support translation is likely to become an industry that will require research skills in the design, evaluation, and testing of new technologies. Translation of knowledge for clinicians may be the initial priority, but priorities will likely expand to include managers, patients, and the public. The passage of the 2010 Affordable Health Care Act for America brings new and increased demands to monitor the success of health reform and identify unintended consequences. To achieve goals of greater efficiency in American health care and better quality, additional investments in health services research and translation and implementation in practice will be needed. The future demand for well-trained health services researchers is currently strong and growing.

RECOMMENDATIONS

Recommendation 8–1: Health services research training should be expanded and strengthened within each NIH institute and center.

Biomedical research has created a growing gap between research advances in biomedical science and the ability to apply them effectively to improve the health of the public. Thus there is a need for more effective health care delivery practices to ensure effective and evidence-based care, and to reduce waste and unnecessary risk to patients.


Recommendation 8–2: AHRQ training programs should be expanded, at a minimum commensurate with the growth in total federal spending on health services research, including comparative effectiveness research.

Recognition of the rising costs of care, with concerns about quality and consistency, have driven increases in services research. Health services research has established an important evidence base to enable patients and health care organizations to evaluate benefits and risks of diagnostic and therapeutic intervention and to compare relative values of older and newer approaches as choices proliferate. This field can also evaluate different approaches to health care delivery and financing, which will allow the nation to get more benefit from the dramatic advances in biomedical science. Ideally, the total numbers of persons being trained in HSR should grow at the same rate as national health



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