Future Directions in Primary Care Research

Reauthorization

The Center for Primary Care Research (CPCR) at AHRQ was named in a statute as part of the 1999 reauthorization process. CPCR was codified as the major Federal source of funding for primary care practice research in the Department of Health and Human Services and the focal point of research on access, quality, and cost of primary care services, as well as patient-provider communication, generalist-specialist issues, and workforce issues in primary care.

The legislation also codified the Medical Expenditure Panel Survey (MEPS) and the U.S. Preventive Services Task Force (USPSTF). It directed the Agency to advance the use of information technology for coordinating patient care and for undertaking quality and outcomes research. The legislation also directed the Agency to address the needs of specific priority populations:

• Residents of inner-city, rural, and frontier areas.


• People with low incomes.


• Elderly, children, women, and minorities.


• People with special health care needs, including disabilities, chronic care, and end-of-life health care.

At the end of last year, Congress passed the fiscal year 2001 appropriations bill for the departments of Labor, Health and Human Services, Education, and related agencies, which the President subsequently signed. The bill recommended $270 million for AHRQ in fiscal year (FY) 2001, which is approximately $70 million above the FY 2000 level and $20 million above the president's request. The increase includes $50 million to conduct and support research to enhance patient safety, initiatives that are expected to involve the nursing community. The increase also provides $10 million to support research related to health care workers and the quality of health care, especially to examine the relationship between the health care workplace and its impact on medical errors and the quality of care provided to patients. The remaining increase will go to activities such as the National Quality Report, research on disparities in care, training, and early career development, and other extramural research initiatives.

In many ways, AHRQ seeks to answer a question put by Rep. John Porter (R-IL), retiring chairman of the House Appropriations Subcommittee on Labor, Health and Human Services (HHS), and Education. "What we really want to get at [in health care research] is not how many reports have been done, but how many people's lives are being bettered by what has been accomplished. In other words, is it being used, is it being followed, is it actually being given to patients—... [W]hat effect is it having on people—" The Agency seeks to assist the health care pipeline, increasing resources for new research on priority health issues to develop tools and talent for a new century, and to translate research into practice. The goals of these activities are improved outcomes for patients, better quality of care, greater access to care, and delivery of care with appropriate cost and use.