Personnel Needs and Training for Biomedical and Behavioral Research Volume 1 (1977) / Chapter Skim
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6 Health Services Research
6 Health Services Research
Pages 128-149
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From page 128... ...
At a time when cor~om~c constraints threaten our ability to bring quality health programs and personnel to individuals and families throughout our nation, it is health services research that seeks to devise more sensible allocations of our collective and finite health resources {White, 1975; White and Henderson, 19761. Through the application of quantitative and systematic research methods, health services research is concerned ultimately with the organization, utilizaticn, and outcomes of health care.
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From page 129... ...
ORIGINS OF FEDERAL SUPPORT Health care delivery systems are shaped by the historical contexts in which they develop. Such factors as economic organization, ideological forces, available technologies and pre-existing professional organization affect access to medical care, distribution of services, and ultimately the quality of health care (Mechanic, 1975)
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From page 130... ...
NATIONAL CENTER FOR HEALTH SERVICES RESEARCH The Congress iona 1 appropriations of 19 55, which Permitted the implementa-~on of the demonstration provisions of the Hi [l-Burton Act, launched health services research by the federal government. By the late 1950's, the NIH also supported a number of noncategorical health services research projects under the general research authority of the Public Health service Act (PHS Act)
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From page 131... ...
Largely through demonstration activities, the Center supported projects to train and deploy physician extenders, to test such new cost containment and f inancing methods as all- incl usive rate reimbursement, to examine the potential of computer technology on health care del ivery, and to standardize the health services data systems withi n state s and nationwide. ~ In ~ 974, Congress clarified the role of the Center through the Health Services Research, Health Stati sties and Medical Libraries Act (PL 93- 353)
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From page 132... ...
From PHS (1976a) ` HEALTH SERVICES RES=RCH IN ADAMHA Federal programs to provide mental health care Services to the nation r epre s ent a drama tic departure f ram tradi t iota service delivery models and generate for health services research a different set of challenges and research problems.
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From page 133... ...
HEALTH SERVICES RESEARCH TN THE NIH Health information systems can assist individuals operating a variety of heal' h services to gain access to information relevant -o the performance of the health services (Alderson, ~ 974)
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From page 134... ...
Such research assists the specification of policies and priorities for continued federal investment in health care. Finally, In the area of alcoholism and drug abuse, health services research has led to the establishment of occupational alcoholism services in the industrial setting and to the creak ion of pilot programs to demonstrate methods 134
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From page 135... ...
The health services investigator apple ies research methods from the di scipl~ne of training to on" or more of the health services problem area s li s ted be low: Problem Areas in 7 Health Services Research health facilities health manpower adulatory care dental health services emergency health services health services for the di sadvantaged long- term care nursing health services pharmacy-related health services economics ~ including health insurance) , inflation, cost containment and production legal aspects of health care, including regulatory studies quality as surance of health services health services organ)
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From page 136... ...
CURRENT MARKET STTUATION FOR TRAINED HEALTH SERVICES RE SEARCH PERSONNEL The NCHSP has provided research training support at both the predoc~ora~ and the postdoctoral level for over a decade. Sims lard y, ADAMHA has provided important training in evaluation research since the latter part of the ~ 960' s, when evaluate ion of the programs of mental health care gained momentum.
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From page 137... ...
In summary, the Committee has concluded that current employment conditions for these trained health services research personnel are good . ASSES SMENT OF THE LABOR FORCE In addition to those individuals who have received federal support f or training in heal th service s research, the present supply of available personnel ~ ncludes a cadre of inve Litigators who have Proved into heal th servi ces research either by virtue of their employment experiences (e.
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From page 140... ...
OUTLOOK FOR THE LABOR MARKET Th ere i s a s igni f ice nt awaken ing o f awarene s s among government aiming strators today of the need to improve national programs of physical and mental health care in the face of inf ration and the high costs of medical care. New approaches to health care are being developed within a very short time frame.
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From page 141... ...
Because health services research will play an increasingly more significant rod e in the federal effort to provide quality health care at a reasonab' e cost, the Committee believes that such research training represents an important national priority. Extens ion of NRSA Authority Throughout its effort to conduct an assessment of health services research personnel, the Committee has had to expand ts considerations to include important training programs other than those of the NTH and ADAMHA.
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From page 142... ...
Because of the role these personnel play in conducting research relevant to national health care concerns, the Committee recommends that stat utory author) ~ y be provided at the earl Yes opportunity through pending ~ egislation, such as the Hospital Cost Containment Act of ~ 977.
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From page 143... ...
In this way, the opportunity for skilled personnel to take up the sophisticated problems of services evaluation In area s of interest to the NTH and ADAMHA wi ll be as sured. The committee believes that the ma jor health care questions today also require the type of health services research training precariously of fered through the programs of the NCHSR.
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From page 144... ...
Indeed, in FY ~ 976 the number of traineeships provided by NIH and ADAMHA for health services research training surpassed the number of fell owships at a ratio of almost ~ ~ traineeships for every fellowship {see Table 1.11. The program of research training provided by the NCHSR since FY ~ 96 ~ represents a similar emphasis on traineeships (NRC, ~ 976a, Table II .
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From page 145... ...
FY 1976 awards reflect an increment in the nether of training awards in health services research reported by the NIH. bIn this year's report the Committee has amended the recommendations it made last year so that the total neither of fellowships and traineeships recommended in FY 1977 is 210 and for FY 1978 is 230.
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From page 146... ...
evidence many of the same characteristics of those in other newl y emerging areas of inquiry. Health services research personnel today primarily represent individuals who have been trained in a basic field or profession and who now occupy positions in health service research by virtue of their career paths, together with those whose interest in health services research led them to seek formal research ~raining.
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From page 147... ...
recommends that up to 5 0 set aside to provide for invest~qators in the methods of level s commensurate with Priority Fields Heal th services research personnel are drawn floor a variety of academic disco plines and professional backgrounds on the f ields problems of _ _ cony r i lout e s un ique ly to th e hea lash car" de livery. to work Each of these solution of the complex quests ons that face the health pi anner today.
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From page 148... ...
6. These ~ and D activities store designed to f it together ~ the same community as an t'Fxperimental Health Services; Delivery Sys tent' ~ ERSES)
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From page 149... ...
Per kof f of st Louis this d :rawn f row 13. of course, some of these individuals are area of healths service s research since it: is their experience and familiarity with the problems of health care delivery that estabI ished this area of enquiry.
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