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5 Findings and Recommendations
Pages 77-84

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From page 77...
... This chapter presents the committee's findings and recommendations on health services research work force and training issues. These conclusions respond to the request from the Agency for Health Care Policy and Research (AHCPR)
From page 78...
... The proportion of the work force whose doctorates are specifically in health services research rather than another field or discipline could not be determined. Given the number, size, and age of programs offering degrees in health services research or closely related fields (primarily health policy or health care management)
From page 79...
... On qualitative grounds, however, the committee foresees growth in the health services research work force if public research funding escapes significant reductions and if competitors in the emerging health care market continue to support growth in knowledge about the quality, effectiveness, and cost of clinical services, the behavioral determinants of health status, and similar questions. SUPPLY IN RELATION TO DEMAND Current Supply and Demand The committee was not able to make an empirically based, quantitative statement about the match between current supply and current demand for health services researchers.
From page 80...
... For the foreseeable future, the committee expects that demand for health services researchers with particular degrees or skills will reflect the increased emphasis that public and private decisionmakers are placing on market forces (and therefore informed consumer choice of health plans and care options) in the health care sector.
From page 81...
... In particular, the committee recommended that AHCPR · consider greater emphasis for some predoctoral and postdoctoral awards on training in areas such as outcomes and health status measurement, biostatistics, epidemiology, health economics, and health policy in which recruiting difficulties have been reported; more explicitly consider in evaluating institutional training program awards how an applicant's training approach, faculty, research opportunities, and training slots relate to personnel shortage areas; and set aside a substantial percentage of institutional awards for innovative programs in health services research, which might be completely new programs or significant modifications of existing programs (see below)
From page 82...
... The committee endorsed the recommendations for health services research training awards that were issued in 1994 by the NRC Committee on National Needs for Biomedical and Behavioral Research Personnel. The recommendations called for 360 National Research Service Awards (NRSA)
From page 83...
... In the context of marketoriented strategies for containing health care costs, abolition or near elimination of AHCPR and its focused health services research and training agenda could undermine the development of knowledge important for effectively functioning and accountable markets and for assessing the impact of health care restructuring on the public's health and, especially, on the availability and quality of care for the nation's most vulnerable children and adults. Although an array of private organizations can be expected to continue and probably increase their investment in outcomes research and similar activities, these efforts taken as a whole are unlikely to substitute for more than a portion
From page 84...
... ~ /~ ~ of govemment-suppoded research Id twining in magnitude, coherence, scope, or concern far long-tc~ consequences. Like other kinds of heakh-rel~ed research Id training in the biomedical Id clinical sciences, hearth services research Id research twining ~e, in considerable measure, public goods Frothy of support by society as s Bold


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