Future Directions in Primary Care Research

Overview

How treatments work in practice rather than in basic and clinical research studies is the domain of the Agency for Healthcare Research and Quality (AHRQ). The Agency conducts and funds research into health services research, especially the effectiveness of treatments—including patient outcomes, treatment costs, and accessibility. AHRQ also is concerned with the quality of care, including major initiatives in patient safety and medical errors. The article outlines the role of the Agency in primary care research, and particularly its role in nursing research. The authors note the role of the Agency in developing a research agenda for nurse staffing research and outline initiatives and programs of interest to nursing researchers.

Although new treatments are studied under controlled conditions—typically with support from the National Institutes of Health (NIH)—to determine their efficacy, how these treatments work in the real world of primary care is more difficult to assess. For example, a controlled trial may show that a particular antibiotic is effective in reducing the inflammation associated with childhood otitis media, but determination of whether antibiotic treatment improves patient outcomes requires a different set of research designs, generally with support from the Agency for Healthcare Research and Quality (AHRQ).

The assessment of the effectiveness of patient outcomes and of treatment cost and accessibility—as opposed to the assessment of treatment efficacy alone—is not a new field of research. Its modern roots go back at least to 1968, when the National Center for Health Services Research was established within what was then the U.S. Department of Health, Education, and Welfare. In 1989, this center became the Agency for Health Care Policy and Research, which was reauthorized by Congress in 1999 as AHRQ. The reauthorization affirms the Agency's existing goals and research priorities:

• Support improvement in health outcomes.


• Strengthen quality measurement and improvement.


• Identify strategies to improve access, foster appropriate use, and reduce unnecessary expenditures.