全球智库信息集成服务系统

The HSR and PCR portfolios of agencies have distinct focus areas based on their individual congressional authorizations, missions, and operational needs

• Stakeholders noted the Agency for Healthcare Research Quality's distinct focus on health care system outcomes, synthesis of evidence, and dissemination of innovations across settings and populations.
• HSR and PCR portfolios of other agencies tend to be organized around specific diseases, body systems, populations, or settings.

Research funded by agencies on similar topics is mostly complementary, but potential overlaps in research portfolios need to be more proactively identified

• Stakeholders generally viewed research funded by agencies on similar topics to address different facets of a topic or combine resources on an underfunded topic.
• Stakeholders considered agencies to be adept at coordination once they recognize overlaps in portfolios. However, discovery of overlaps was described as "sporadic" or "accidental."

Federally funded HSR and PCR have a wide range of impacts that are often cumulative across research portfolios

• Impacts ranged from scientific and professional knowledge to changes in health care systems and services, policies, and patient and societal outcomes.

The variety of gaps in HSR and PCR reflect the challenge of improving U.S. health care, which requires new research approaches and strategies to prioritize research efforts

• Many research gaps are driven by the complexity and pace of health care change.
• General gaps include producing timely results for improving health care delivery, developing methods to examine complex dynamics of health care change, communicating results to guide implementation, and using theory to connect findings and advance knowledge on health care improvement.

This report presents the results of a congressionally mandated, independent assessment of federally funded health services research (HSR) and primary care research (PCR) spanning the U.S. Department of Health and Human Services (HHS) and U.S. Department of Veterans Affairs (VA) from FYs 2012 to 2018. Through technical expert panels, stakeholder interviews, and a systematic environmental scan of research grants and contracts funded by HHS and the VA, the authors characterize the distinct contributions of agencies in these departments to the federal HSR and PCR enterprise. The authors also identify opportunities to improve detection and coordination of overlap in agency research portfolios, the impacts of HSR and PCR and how they cumulate across research portfolios, and gaps in research funding, methods, and dissemination. The authors offer recommendations to maximize the outcomes and value of future investments in federal HSR and PCR to better guide and serve the needs of a complex and rapidly changing U.S. health care system.

• Chapter One

  Introduction

• Chapter Two

  Study Methods

• Chapter Three

  Breadth and Focus Areas of Federal Agency Research Portfolios in HSR and PCR

• Chapter Four

  Overlap and Coordination of Federal Agency Research Portfolios in HSR and PCR

• Chapter Five

  Impacts of Federally Funded HSR and PCR

• Chapter Six

  Research Gaps and Prioritization of Federally Funded HSR and PCR

• Chapter Seven

  Conclusions and Recommendations

• Appendix A

  Details on Scan Data Set, Manual Reviews, Algorithm Classification Methods, and Supplemental Scan Results

• Appendix B

  Detailed Research Domain Framework Definitions and Classification Rules

• Appendix C

  Detailed Descriptions of Agency Research Portfolios

• Appendix D

  dddd

• Appendix E

  List of Other Research Gaps Identified by Study Participants