February 1, 2013
Volume 77, Number 2
FAER Report: Healthcare Services Research Grant Opportunity: Why the Time Is Now
Lee A. Fleisher, M.D.
Mark D. Neuman, M.D., M.Sc.
With concerns regarding the increasing costs of health care in the United States, policymakers have increasingly focused on identifying strategies to improve the health of the U.S. population while simultaneously lowering costs. In this context, health care services research – which the Agency for Healthcare Research and Quality (AHRQ) defines as “a multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structure and processes, health technologies, and personal behaviors affect access to healthcare, the quality and cost of healthcare and alternately our health and well-being”1 – will play an increasingly important role in shaping the organization and delivery of health care in the U.S. over the coming decades.
For anesthesiologists, the growing importance of health care services research in the landscape of health care policy creates important opportunities to contribute to improving the value of the care delivered to the population, particularly in the area of surgical care and pain management. Historically, anesthesiologists, departments of anesthesiology and key professional societies within anesthesiology were in the vanguard of the patient-safety movement, pioneering methods such as the closed claims analysis as a means to learn about the causes of error. Nonetheless, over the past several decades, other specialties, such as internal medicine, pediatrics, family medicine and general surgery, have made substantial investments in the development of young investigators equipped with advanced knowledge and training necessary to carry out cutting-edge health care services research. As a truly multidisciplinary field, health services research employs methods from clinical epidemiology, biostatistics, health economics, medical sociology and cultural anthropology. As a result, the training needed to perform high-quality health services research may be markedly different than the preparation available in an introductory statistical course.
Other specialties have begun to realize the need for such training; for example, the American College of Surgeons has a longstanding partnership with the Robert Wood Johnson Foundation Clinical Scholars Program, a leading health services research training program for young physicians, and annually sponsors surgical trainees to gain advanced training in research methods through this program. We in anesthesiology must start preparing a generation of researchers capable of ensuring that our specialty continues to lead in the area of delivering the highest-quality perioperative care, periprocedural care and pain management. By understanding both the methodology and the policy implications of the findings, these future investigators will be able to help lead the specialty in areas in which we can have the most impact from a care delivery perspective and allow us to measure our impact on public health in the United States.
To address this need, the FAER Board of Directors partnered with the Anesthesia Quality Institute (AQI) to offer a pilot mentored grant for early-career investigators: the Mentored Research Training Grant in Healthcare Services Research. Similar to FAER’s existing Mentored Research Training Grants, the applicant is required to spend two years with
75 percent dedicated research time. The applicant will be expected to either have formal training or obtain training in disciplines related to health care services research during the grant period. The $175,000 grant emphasizes that the trainee will interact with the ASA Director of Health Policy and/or the director of the AQI.
There is a real need for well-trained individuals to help us study our current practices and learn from them. Through this new training grant mechanism, FAER and AQI, with the support of ASA, has taken a major step in ensuring that those individuals will exist within the specialty by supporting their early training.
Lee A. Fleisher, M.D. is Robert D. Dripps Professor and Chair, Department of Anesthesiology and Critical Care, and Professor of Medicine, Perelman School of Medicine; Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
Mark D. Neuman, M.D., M.Sc. is
Assistant Professor of Anesthesiology and Critical Care, Perelman School of Medicine, and Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
1. Agency for Healthcare Research and Quality. An organizational guide to building health services research capacity: contract final report. AHRQ website. http://www.ahrq.gov/fund/hsrguide/hsrguide.htm. Accessed December 6, 2012.