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Performance Budget Submission for Congressional Justification

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Activities in Support of All Goals

Health Services Research Training

As the Nation's health care delivery systems continue to change, the need for individuals trained to conduct research and perform analyses to assist decisionmakers in both health policy and health care delivery settings is crucial. What follows in a summary of some of AHRQ's health services research training programs.

National Research Service Awards (NRSAs)

AHRQ supports predoctoral and postdoctoral training through the National Research Service Award (NRSA) program. AHRQ awards NRSA training grants to institutions for predoctoral and postdoctoral training (the Institutional Training Awards) as well as individual NRSA fellowships to applicants who have completed their doctoral degrees (the AHRQ Fellowship Awards). These grants are presently funding 184 trainees.

Career Awards

Beginning in Fiscal Year 2000, AHRQ will also foster incremental growth, approximately four awards per year, in career development activities. These awards, provided to individuals embarking on a research career, allow individuals time and resources to gain experience in carrying out actual research. The intent is to provide transitional support for newly trained investigators in order to launch them on research careers. This program will foster the next generation of health services researchers. AHRQ supports two types of career awards:

Violence Against Women Fellowship Program

In Fiscal Year 2000, AHRQ will begin implementation of the Violence Against Women (VAW) Fellowship program. This program will provide promising academic and clinical professionals with an opportunity to expand their knowledge and understanding of violence against women issues through a structured development program. The Fellowship program would be broadly designed to serve the Department as a whole, and fellows would apply to any Agency in the Department able to support the fellowship.

Dissemination Activities

AHRQ promotes widespread distribution and implementation of its information and research products through a variety of dissemination methods: publication in professional journals; provider and consumer materials, media events and outreach; interviews and story placement with medical/trade press and organizations' newsletters; and articles in the popular press. AHRQ also employs public-private partnerships, direct mail and the World Wide Web to distribute its information.

AHRQ's Web site

Use of AHRQ's Web site continued to increase in FY1999, with more than 15.5 million hits, compared with 10 million hits the previous year. User sessions almost doubled—892,175, compared with 452,000. Approximately 3,000 inquiries were handled through the Web site mailbox, up from 2,500 the previous year. Uploaded files and documents nearly tripled—4,000 compared with 1,450.

The AHRQ Web site also provides access to many of the reports from the first and second rounds of the Evidence-based Practice Centers. The full text of these reports can be obtained at the National Library of Medicine, accessible online.

The "healthfinder®" gateway site, developed and maintained by the Department of Health and Human Services, was prominently featured on the AHRQ site, and in turn provided 44,000 referrals to the Agency's online consumer health and patient information materials. The Agency continued to work with the National Library of Medicine to upload evidence reports, technology assessments, and preventive services materials for clinicians on the full-text retrieval system HSTAT.

AHRQ's site is in the process of being redesigned to address feedback from a customer satisfaction survey of the site. The protosite will be tested for usability with various constituencies to ensure the quality has been upgraded, the content is accessible, and the navigational approaches facilitate information retrieval for users.

Nearly 5,000 sites are linked to AHRQ, up from 2,200 the previous year, and the Web site has been lauded for its credibility and content in numerous journal and magazine articles. Examples of awards include:

  • "Web Pick" by HMS Beagle, a biweekly webzine for biological and medical researchers, and BioMedLink, a comprehensive, evaluated database of biological and medical Web sites.
  • "Best Medical Resource" site by the Pfizer Medical Humanities Initiative, a research and educational program for enhancing the patient-physician relationship.
  • "Seal of Approval" by Medinex, an online health community for doctors and patients.
  • "Key Medical Resource" site by the Association of Program Directors in Internal Medicine for teaching faculty in Internal Medicine.
  • "Silver Platter Site" by Ask Jeeves, the Internet's premier question-answering service, handling millions of questions each day.
  • "Valuable Resource" by CiteLine for quality of content, overall usability and value to health care professionals.
  • "Top Health Association" site on Worldwide Nurse, the Internet's nursing resource.
  • "National Health Information Award" from the Health Information Resource Center for consumer health information and decisionmaking.

User Liaison Program (ULP)

During Fiscal Year 1999, AHRQ's User Liaison Program (ULP) continued producing national workshops for its target audience—senior and local health officials. ULP also developed its first Web-based distance learning workshop that these officials can access from their desktops. Workshop topics were identified for ULP by State and local officials as their current health policy priorities and were designed to help inform their decisionmaking. In Fiscal Year 2000, ULP plans to continue developing workshops and other programs for this audience.

In Fiscal Year 1999, ULP held 17 onsite meetings more than 800 health care policymakers and other participants, attending from 48 States as well as the District of Columbia, Puerto Rico, the Virgin Islands, Micronesia, and Guam. Topics addressed included:

  • "The Uninsured and the Safety Net: Trends and Challenges."
  • "Assessing Quality: Beyond the Basics."
  • "Using Evidence: Making Disease Management and Health Benefit Coverage Decisions."
  • "CHIP—What's Happening? What's Next?"

Another workshop was co-sponsored by the National Conference of State Legislatures and was targeted to newly elected State legislators or those newly assigned to health committees. Another onsite meeting was for Texas officials interested in consumer health information and another, "Aging in Rural Areas: Preparing for the Future," was co-sponsored by the Office of Rural Health Policy of the Health Resources and Services Administration.

ULP's Web-based distance learning program, "CHIP: Implementing Effective Programs and Understanding Their Impacts," was developed in Fiscal Year 1999 to provide an overview of the key implementation issues facing policymakers and senior State program managers. Regular revisions are ongoing, so the program will stay current in our rapidly changing insurance environment.

At least 12 onsite meetings are planned for Fiscal Year 2000. Topics include the following: "Prescription Drug Coverage: What Can We Afford? How Do We Decide?"; "How Safe Is Our Health Care System? What States Can Do To Improve Patient Safety and Reduce Medical Errors"; and "Designing Health Care Systems That Work for People With Chronic Illnesses and Disabilities."

ULP also will publish a paper addressing strategies for coordinating publicly funded health care coverage for children. Additionally, ULP plans to develop other tools to disseminate research information to State and local health policymakers. Such tools include teleconferencing and Web-based programs.

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Funding Summary

Authorizing Legislation—Section 30l and Title IX of the Public Health Service Act

Budget Authority/ FTEs 1999
Actual
2000 Final
Appropriation
2001
Estimate
Increase or Decrease
Budget
Authority
$97,967,000
($41,347,000)
$107,739,000
($57,576,000)
$0
($206,593,000)
-$107,739,000
(+$149,017,000)
Full-Time
Equivalents
212 243 252 +9

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Prior Year Funding

Funding for the Research on Health Costs, Quality and Outcomes program during the last five-years has been as follows:

Year Amount FTEs
1997 $102,863,000 216
1998 $107,980,000 219
1999 $139,314,000 212
2000 $165,315,000 243
2001 $206,593,000 252

Sources of Research on Health Cost, Quality and Outcomes funding follow:

Year Budget Authority 1% Evaluation Total
1997 94,113,000 8,750,000 $102,863,000
1998 88,074,000 19,906,000 $107,980,000
1999 97,967,000 41,347,000 $139,314,000
2000 Appropriation 112,739,000 52,576,000 $165,315,000
2001 Request -0- 206,593,000 $206,593,000

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