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New Report Says Better Coordination of Resources Along Regional Lines is Essential to Bioterrorism Preparedness

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Press Release Date: May 7, 2004

Coordinating resources across local and state lines—also known as regionalization—may benefit some bioterrorism preparedness and response capabilities, but more research is needed to find the best ways of coordinating those resources, according to a new report released today by the Agency for Healthcare Research and Quality.

The new report, Regionalization of Bioterrorism Preparedness and Response, identifies three key ways regionalization can make a difference in communities' response.

First, regionalization may help communities with surge capacity—health care system's ability to rapidly expand beyond normal services—to provide critical response services such as medical care, distribution and dispensing of preventive drugs, outbreak investigation, and emergency management.

Second, regionalization may be the best way for state and local governments to use scarce resources by joining with other communities to develop teams of trained response personnel and maintain supplies of response equipment.

Third, pre-existing agreements as well as written plans that specify roles, payment, and chain of command may help in coordinating the numerous response organizations likely to be involved.

"These findings confirm the importance of working together under extreme circumstances," said AHRQ Director Carolyn M. Clancy, M.D. "I'm pleased to report that AHRQ, along with its federal partners, has many studies underway looking at regional approaches to many of the areas identified by this new report."

The researchers also found that:

  • Most federal, state, and local organizations likely to be part of a regional response were designed independently, or for purposes other than responding to bioterrorism, and efforts to coordinate them for bioterrorism preparedness have only just begun.
  • Supply chain management concepts used in manufacturing are directly relevant to those parts of a bioterrorism response that require the purchasing, inventorying, distributing, and rapid dispensing of needed supplies.
  • Pre-event hospital designation (such as limiting high-cost specialty care to specifically designated hospitals with increased experience in treating severely injured patients) and formalized protocols for pre-hospital and hospital trauma care (such as first responders knowing where and how to rapidly transport exposed patients) contribute to improved patient outcomes.

The report was prepared by a team of researchers led by Dena Bravata, M.D., at AHRQ's Evidence-based Practice Center at Stanford University-University of California, San Francisco. In reviewing the available literature on this topic, the researchers found few evaluations of systems relevant to preparedness, and even fewer evaluations of the regionalization of systems relevant to bioterrorism preparedness. They recommend that future research focus on the costs and benefits of regionalization of surveillance, inventory management and distribution systems, and information management.

A summary of the report, Regionalization of Bioterrorism Preparedness and Response, can be found at Printed copies of the summary and full report are available by calling AHRQ's Publications Clearinghouse at 1-800-358-9295 or by sending an E-mail to

The report is one of more than 50 studies, workshops, conferences, and other activities funded under the Agency's bioterrorism research portfolio ( AHRQ sponsors research that provides the evidence base for tools and resources needed in bioterrorism planning and response.

For more information, please contact AHRQ Public Affairs: (301) 427-1271, or (301) 427-1865.


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