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Health Outcomes for Older People: Questions for the Coming Decade
Government agencies and private foundations should support training and education opportunities in health outcomes research.
The successful implementation of an outcomes research agenda depends not only on the persuasive identification of important issues and the securing of funding but also on the availability of well-trained and committed researchers.
Although the private sector will provide some support, governmental and foundation aid is needed to ensure that the health outcomes research workforce is adequate in terms of overall size, appropriateness of training, and sensitivity to issues involving older individuals.
The health outcomes research workforce has two distinct components. It includes:
investigators and researchers who originate, design, supervise, and report basic and applied research; and
individuals who analyze health outcomes information and apply certain tools of health outcomes research in management, policy, and service delivery settings.
A recent IOM committee (IOM, 1995) concluded that well-trained health services researchers with practical experience in health care organizations (e.g., integrated health care systems, insurance companies) and in managing research units appear to be in short supply. A survey of employers of health services researchers, commissioned as part of that study, found that employers stated that they have the greatest difficulty in recruiting researchers with expertise in the area of “outcomes/health status measurement.” Employers also indicated that within the next five years they expected to recruit more researchers in this area than in any other. However, although employers and private health plans do cover some of the costs and arrange or provide some of the care for older individuals, their primary focus is on younger age groups. Even taken as a whole, these efforts by private organizations are unlikely to substitute for more than a portion of government- and foundation-supported research and training in magnitude, coherence, scope, or concern for long-term consequences.
The Agency for Health Care Policy and Research provides some support of education and training through dissertation grants and National Research Service Awards. Other government agencies, including some components of the