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Press Release Date: June 12, 1997
The Agency for Health Care Policy and Research today announced
it has earmarked more than $1 million in funding for small
project grants in the remainder of fiscal year 1997. This funding
is in addition to 12 grants listed below, worth more than
$800,000, that AHCPR is also announcing today.
Applicants for the new funds are encouraged to address the
AHCPR strategic goals described in the Notice
of Program Emphases for the AHCPR Small Project Grant Program
published in the April 25, 1997 NIH Guide. To be
considered for FY 1997 funding, applications should be received
no later than July 7.
The 12 grants announced today will help track the impact of
managed care on the health care system and improve the quality of
health care services provided in primary care settings. "The
findings from these studies will provide information that will be
invaluable to primary care physicians and other frontline
providers as they work to the improve the quality of the health
care services they provide every day," said John M.
Eisenberg, M.D., AHCPR administrator. "These small grants
enable researchers to obtain the necessary funds to test new ways
of addressing the nation's health care challenges."
Organization Typology of Emerging Health
Organizations. Principal investigator: Stephen
Shortell, M.B.A., Ph.D., Northwestern University,
Chicago, IL; $72,715; 6/1/97-5/31/98.
This study will:
1) develop a framework that identifies key structural and
strategic elements of newly emerging health
organizations; 2) make the framework operational with
data obtained from American Hospital Association that
capture the horizontal and vertical organizational
alignment; 3) identify classes of health care
organizations that are similar in their configuration and
structure; and 4) identify the key policy issues and
research questions relating to each of these classes of
Immunization Barriers: A Study of Pediatric Nurse
Practice. Principal investigator: Richard K.
Zimmerman, M.D., M.P.H., University of Pittsburgh,
Pittsburgh, PA; $74,883; 6/1/97-5/31/98.
will expand a previously funded AHCPR study of barriers
to the provision of childhood immunizations. While the
earlier study focused on barriers experienced by primary
care physicians, the current project will survey
pediatric nurse practitioners, who are important
providers of childhood immunizations in managed care
settings and in underserved areas. The project will
investigate whether such factors as reimbursement
policies and concerns about vaccine-related lawsuits
affect immunization practices.
Factors Influencing Hospital Contracting With
Managed Care Plans. Principal investigator: Jack
Zwanziger, Ph.D., University of Rochester, Rochester
NY; $36,688; 6/1/97-5/31/98.
This study will complete
development of a unique internally developed data base
and then use it to study the factors influencing the
contracting decision between managed care plans (health
maintenance organizations and preferred provider
organizations) and general acute care hospitals in a
sample of larger urban areas.
Feasibility of a New Approach to Pain Assessment
and Management in a Primary Care Practice.
Principal investigator: Tim A. Ahles, Ph.D., Dartmouth
College, Hanover, NH; $80,961; 6/1/97-5/31/98.
research will design a rapid assessment and management
approach for treating pain in busy community practices by
developing an intervention using the Dartmouth COOP
Clinical Improvement System and a telephone-based nurse
Underinsurance and Mortality. Principal
investigator: Peter Franks, M.B.B.S., M.S., Highland
Hospital of Rochester, Rochester, NY; $66,828;
This study will examine, in adults over
65, the relationships between health insurance, a
potentially modifiable health care access factor, and
mortality in order to provide information that will
assist in planning efforts to improve health.
Communication Skills Training for Primary Care
Programs. Principal investigator: Donald J.
Cegala, Ph.D., Ohio State University, Columbus, OH;
This project will test the
effects of communication skills training that instructs
patients in how to seek, provide, and verify
understanding of information during a primary care
Assessing Health Data Needs in a Changing
Environment. Principal investigator: William D.
White, M.A., Ph.D., University of Illinois, Chicago, IL;
The project will critique the
existing health care data system from the perspective of
a "value chain" analysis, which examines how
value is added in various stages of the production
process. This analysis is useful in identifying the
importance and efficiency of tasks. The study also will
develop a methodological framework for applying a value
chain approach to health care data collection focusing on
hospitals and physicians, perform a small pilot study
applying this value chain methodology, and assess the
potential feasibility and robustness of this methodology
and consider possible lessons from the analysis for
improving the design of health care collection.
Comparing Hospital and Office-based Primary Care.
Principal investigator: David Blumenthal, M.D., M.P.P.,
Massachusetts General Hospital, Boston, MA; $71, 813;
This study is designed to develop
reliable and valid measures of doctor trust among
patients, evaluate the effects of trust on economic
incentives and administration rules, and evaluate the
relationship between patient trust and patient
satisfaction with care, voluntary change in health
insurance plans, and physician job satisfaction.
Effects of Managed Care on Patient Travel
Patterns and Size of Hospital. Principal
investigator: Glenn A. Melnick, Ph.D., RAND Corporation,
Santa Monica, CA; $75,212; 6/1/97-5/31/98.
study will test whether selective contracting and price
competition has altered patient admission and travel
patterns, and if so, whether greater regionalization is
evident in providers offering lower prices and/or better
Employer-paid Health Insurance and Labor Market
Changes. Principal investigator: Lisa A.
Cubbins, Ph.D., University of Cincinnati, Cincinnati,
OH; $38,177; 6/1/97-5/31/98.
This research will
examine how women, racial and ethnic minorities, and the
working poor, have fared given changes in labor market
conditions that affect employer-paid health insurance.
Domestic Abuse, Health Status, and HMO Health
Care Use. Principal investigator: Diana Shye,
Ph.D., Kaiser Foundation Research Institute, Oakland,
CA; $78,158; 6/1/97-5/31/98.
The study will use
existing research and HMO administrative databases and a
descriptive analytic design to examine, in samples of
adult and child HMO members: 1) the demographic profile
of exposure to domestic violence by key sociodemographic
traits; 2) the relationship between domestic violence
exposure and health status and the degree of consistency
of this relationship according to sociodemographic
traits; 3) the relationship between abuse exposure,
health status, and use rates for general and speciality
mental health office visits, pharmacy dispenses for
psychiatric and non-psychiatric medications, diagnostic
procedures, urgency care and emergency room visits, and
inpatient days; and 4) the mechanisms by which abuse
status and health status are related to utilization and
Care-seeking and Consultation with Spine
Specialists. Principal investigator: Timothy S.
Carey, M.D., M.P.H., University of North Carolina, Chapel
Hill, NC; $55,796; 7/1/97-6/30/98.
This study will
analyze the costs and outcomes of care for persons who
consult two or more different health care providers
(including primary care physicians, chiropractors,
orthopedic and neurologic surgeons) for the treatment of
a single episode of low back pain. The research will
examine the factors associated with consultation or
referral and the consequences of over- and
under-utilization of spine specialists in the treatment
of low back pain.
Applications for AHCPR small project grants are accepted on an
ongoing basis and should be submitted to: Small Grants Research
Projects, Agency for Health Care Policy and Research, 2101 East
Jefferson Street, Suite 400, Rockville, MD 20852-4908.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855, (KMigdail@ahrq.gov), Salina V. Prasad, (301) 427-1864 (SPrasad@ahrq.gov).