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Agency for Healthcare Research Quality

AHRQ Profile

Advancing Excellence in Health Care

The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services. AHRQ was formerly known as the Agency for Health Care Policy and Research.


AHRQ's Customers
AHRQ's Strategic Goals
The Health Services Research Pipeline
Closing the Gap: From Knowledge to Practice
Impact of AHRQ's User-Driven Research
AHRQ Projects and Quality Improvement Efforts


Mission: To support research designed to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The research sponsored, conducted, and disseminated by the Agency for Healthcare Research and Quality (AHRQ) provides information that helps people make better decisions about health care.

Created: December 1989 as the Agency for Health Care Policy and Research (AHCPR), a Public Health Service agency in the Department of Health and Human Services (HHS). Reporting to the HHS Secretary, the Agency was reauthorized on December 6, 1999, as the Agency for Healthcare Research and Quality.

Sister agencies include the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Care Financing Administration, and the Health Resources and Services Administration.

Budget: $329.6 million. Nearly 80 percent of AHRQ's budget is awarded as grants and contracts to researchers at universities and other research institutions across the country.

Staff: Approximately 300

Director: Carolyn Clancy, M.D

Acting Deputy Director: Kathleen Kendrick

Main functions: AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers—patients and clinicians, health system leaders, purchasers, and policymakers—make more informed decisions and improve the quality of health care services.

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AHRQ's Customers

  • Clinical decisionmakers: The evidence developed through AHRQ-sponsored research and analysis helps clinicians, consumers, patients, and health care institutions to make informed choices about what treatments work, for whom, when, and at what cost.
  • Health care system decisionmakers: Health plan and delivery system administrators use the findings and tools developed through AHRQ-sponsored research to make choices on how to improve the health care system's ability to provide access to and deliver high-quality, high-value care. Purchasers use the products of AHRQ-sponsored research to obtain high-quality health care services.
  • Public policy decisionmakers: Public policymakers use the information produced by AHRQ to expand their capability to monitor and evaluate changes in the health care system and to devise policies designed to improve its performance. Federal, State, and local policymakers as well as private-sector policy advisory groups such as the Institute of Medicine (IOM), professional societies, patient advocacy groups, and health care associations make decisions based on AHRQ information.

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AHRQ's Strategic Goals

AHRQ's strategic goals reflect the needs of its customers. These goals are to:

  • Support improvements in health outcomes. The field of health outcomes research examines the end results of the structure and processes of health care on the health and well-being of patients and populations. A unique characteristic of this research is the incorporation of the patient's perspective in the assessment of effectiveness. Public and private-sector policymakers are also concerned with the end results of their investments in health care, whether at the individual, community, or population level.
  • Strengthen quality measurement and improvement. Achieving this goal requires developing and testing quality measures and investigating the best ways to collect, compare, and communicate these data so they are useful to decisionmakers. AHRQ's research will also emphasize studies of the most effective ways to implement these measures and strategies in order to improve patient safety and health care quality.
  • Identify strategies that improve access, foster appropriate use, and reduce unnecessary expenditures. Adequate access and appropriate use of health care services continues to be a challenge for many Americans, particularly the poor, the uninsured, members of minority groups, rural and inner city residents, and other priority populations. The Agency will support studies of access, health care utilization, and expenditures to identify whether particular approaches to health care delivery and payment alter behaviors in ways that promote access and/or economize on health care resource use.

In addition the 1999 reauthorizing legislation directs AHRQ to:

  • Improve the quality of health care. AHRQ is to coordinate, conduct, and support research, demonstrations, and evaluations related to the measurement and improvement of health care quality. This includes a call for the development of an annual report on national trends in health care quality beginning in fiscal year 2003. AHRQ is also to disseminate scientific findings about what works best and facilitate public access to information on the quality of, and consumer satisfaction with, health care.
  • Promote patient safety and reduce medical errors. AHRQ is to develop research and building partnerships with health care practitioners and health care systems and establish a permanent program of Centers for Education and Research on Therapeutics. These initiatives will help address concerns raised in a 1999 report by the Institute of Medicine (IOM) that estimates as many as 98,000 patients die as a result of medical errors in hospitals each year. (Select for information on the IOM Report.)
  • Advance the use of information technology for coordinating patient care and conducting quality and outcomes research. AHRQ is to:
    • Promote the use of information systems to develop and disseminate performance measures.
    • Create effective linkages between health information sources to enhance health care delivery and coordination of evidence-based health care services.
    • Promote protection of individually identifiable patient information used in health services research and health care quality improvement.
  • Establish an Office of Priority Populations. AHRQ is to ensure that the needs of these populations (low-income groups, minorities, women, children, the elderly, and individuals with special heath care needs) are addressed throughout the Agency's intramural and extramural research portfolio. Beginning in fiscal year 2003, this will include an annual report on prevailing disparities in health care delivery as it relates to these priority populations.

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The Health Services Research Pipeline

The Agency achieves its mission through health services research that reflects a pipeline of activities that together build the infrastructure, tools, and knowledge for improvements in the American health care system. The pipeline comprises three critical and interdependent priorities:

  1. New knowledge on priority health issues. This is the essential knowledge base that investigators create which enables us to understand the determinants of the outcomes, quality, and costs of care as well as identify instances when care falls short of achieving its intended outcomes. AHRQ recognizes that the future of and vision for health services research come from the scientific community—investigators who are on the front line of the clinical, health system, and health policy problems to be resolved through research. Because the nurturing of novel research approaches, concepts, and directions is essential for progress within the health services research field, AHRQ actively encourages and supports peer-reviewed, investigator-initiated research.
  2. New tools and talent for a new century. These tools apply and translate new knowledge into instruments for measurement, databases, informatics, and other applications that can be used to assess and improve care. In addition, AHRQ works to ensure that the infrastructure for health services research remains strong, including building the supply of talented researchers. The Agency encourages students to enter the field of health services research, sponsors over 20 predoctoral and postdoctoral training programs, nurtures the careers of new investigators, and promotes the careers of established researchers.
  3. Translating Research Into Practice. The final step of the pipeline focuses on closing the gap between what we know and what we do. AHRQ funds research and demonstrations to translate the knowledge and tools acquired into measurable improvements in health care. In addition, AHRQ develops partnerships with public and private-sector organizations to disseminate the knowledge and tools for use in the health care system.

Select to access How AHRQ's Research Helps People.

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Closing the Gap: From Knowledge to Practice

In fiscal year 1999, AHRQ began its Translating Research Into Practice (TRIP) initiative aimed at implementing evidence-based tools and information in diverse health care settings among practitioners caring for diverse populations. In November 1999, the Agency awarded its first grants under this initiative, designed to generate new knowledge about approaches which are effective and cost-effective in promoting the utilization of rigorously derived evidence to improve patient care. Currently, 14 TRIP-I studies are under way on topics such as:

  • Smoking cessation.
  • Chlamydia screening of adolescents.
  • Diabetes care in medically underserved areas.
  • Treatment of respiratory distress syndrome in preterm infants.

In fiscal year 2000, AHRQ released the "Translating Research Into Practice II" Request for Applications. TRIP II focuses on continued development of partnerships between researchers and health care systems and organizations (e.g., integrated health service delivery systems, academic health systems, purchaser groups, managed care programs including health maintenance organizations (HMOs), practice networks, worksite clinics) to help accelerate and magnify the impact of practice-based, patient outcome research in applied settings. Thirteen studies are now underway in response to this initiative.

Select to access TRIP II RFA.

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Impact of AHRQ's User-Driven Research

AHRQ's research, data, clinical improvement tools, and quality measurement and improvement tools are used by its customers to enhance the quality of care they provide and purchase and to make more informed health care decisions. Research grants are subject to the same scientific peer review and ranking used by the National Institutes of Health. Examples of intramural and extramural research at work within the Nation's health care system include the following:

Outcomes Research

Supporting improvements in health outcomes remains one of the Agency's underlying research priorities. AHRQ's outcomes research initiatives, including its Patient Outcomes Research Teams (PORTs), pharmaceutical outcomes projects, and medical effectiveness research, have helped build the science base underlying day-to-day clinical practice and health policy.

For example, findings from AHRQ's stroke PORT led in part to development of guidelines by the American College of Physicians, American Hospital Association, and Joint Council of Vascular Surgeons. Analysis of findings from AHRQ's cataract PORT influenced Blue Cross/Blue Shield plans in two States to change payment policies relating to which patients were most likely to benefit from cataract surgery.

In addition, the VF-14 instrument to measure functional status in patients with cataracts (also developed as part of the cataract PORT):

  • Is now considered the gold standard for this purpose.
  • Has been translated into several languages.
  • Is used in about a dozen countries as part of ophthalmology practice.

Diabetes Treatment

AHRQ's work in the area of diabetes treatment has led to a collaboration among the Health Care Financing Administration, National Committee for Quality Assurance, American Academy of Family Physicians, American Diabetes Association, and Foundation for Accountability to develop the Diabetes Quality Improvement Project (DQIP). DQIP comprises a set of national diabetes performance measures that will allow for comparisons of quality and stimulate efforts to improve the care for people with diabetes.

Ethnic and Racial Disparities in Health Care

Findings from one Agency-supported study showed that blacks are 13 percent less likely to undergo coronary angioplasty and about one-third less likely to undergo bypass surgery than whites. In a study of preschool children hospitalized for asthma, only 7 percent of blacks and 2 percent of Hispanics, compared with 21 percent of whites, were prescribed routine drug treatment to prevent future hospitalizations. According to AHRQ's Medical Expenditure Panel Survey data for children under age 18, Hispanics were nearly 3 times as likely and blacks over twice as likely as whites to lack a usual source of health care.

Researchers investigating these and other issues relating to minority health now have access to a data collection instrument that assesses the interpersonal processes of care from the perspective of minority patients. This instrument was developed with AHRQ support by the Medical Effectiveness Research Center for Diverse Populations at the University of California, San Francisco.

Select for more information about disparities in health care.

Reducing Medical Errors and Promoting Patient Safety

AHRQ research has shown that system-level failures led to three-fourths of adverse drug events in the hospital systems the investigators studied. According to another Agency-sponsored study, preventable adverse drug events in a 700-bed teaching hospital accounted for half of the total cost of $5.6 million attributable to such events in 1 year, even though they made up less than a third of the total number of events. As the operating chair of the Quality Interagency Coordination Task Force—the Government-wide collaboration on health care quality issues—AHRQ has coordinated the Federal response to the Institute of Medicine's report on medical errors. In September and November 2000, AHRQ organized meetings involving funding organizations from the public and private sectors to establish a preliminary research agenda on medical errors.

Select for more information on medical errors.

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AHRQ Projects and Quality Improvement Efforts

In fiscal year 2001, AHRQ's focus on improving patient safety includes a broad $50 million research initiative that will:

  • Further understanding of when and how errors occur.
  • Identify causes of errors.
  • Develop the research capacity needed to foster a national strategy to improve patient safety.
  • Work with public- and private-sector partners to apply evidence-based approaches to the improvement of patient safety.

In February 2001, AHRQ issued the third in a series of six requests for applications the Agency expects to issue in fiscal year 2001 as part of its new patient safety and medical errors research program. A new AHRQ priority in fiscal year 2001 will be a focus on the health of workers in the health care field and the quality of the health care workplace. A $10-million appropriation will allow AHRQ to support research on the impact of health care on the well-being and productivity of the Nation's health care workers.

In addition to these projects, AHRQ's major ongoing quality improvement efforts include the following.

Centers for Education and Research on Therapeutics (CERTs)

The Healthcare Research and Quality Act of 1999 established the Centers for Education and Research on Therapeutics as a permanent program. The purpose of this initiative is to help reduce adverse drug events and promote the safe and effective use of pharmaceuticals by conducting state-of-the-art research that increases awareness of the uses and risks of new drugs and drug combinations, biological products, and devices as well as of mechanisms to improve their safe and effective use. The CERTs initiative was originally established as a short-term demonstration program under the Food and Drug Administration Modernization Act of 1997. AHRQ now supports seven centers under the CERTs program.

Select to access the CERTs Fact Sheet.

Consumer Assessment of Healthcare Providers and Systems (CAHPS®)

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program is AHRQ's multi-year initiative that supports the assessment of consumers' experiences with health care.

CAHPS® is an easy-to-use kit of survey and report tools that provides reliable and valid information to help consumers and purchasers assess and choose among health plans. CAHPS® 2.0 revises the earlier CAHPS® 1.0 questionnaires (English and Spanish versions) and includes a supplemental set of items required for accreditation by the National Committee for Quality Assurance. CAHPS® 3.0 shifts the focus from developing surveys to developing tools and resources to support the use of CAHPS® surveys.

CAHPS® incorporates the perspectives of consumers, purchasers, and health plans; can be used to assess both fee-for-service and managed care systems; and applies across commercial, Medicare, and Medicaid populations.

CAHPS® surveys are being used by more than 20 States, 10 employer groups, the Medicare Program, the Federal Employees Health Benefits Program, a wide range of health plans, and a division of Ford Motor Company. More than 93 million Americans now receive information on health plans resulting from CAHPS®.

Select to access more information on CAHPS®.

Quality Measures

The most current evidence-based quality measures and measure sets to evaluate and improve the quality of health care are available from the National Quality Measures Clearinghouse™. Select to access more information at:

Healthcare Cost and Utilization Project (HCUP)

AHRQ sponsors the Healthcare Cost and Utilization Project, a Federal-State-industry partnership to build a multi-State health care data system for research, policy analysis, and quality measurement and improvement. HCUP comprises a family of databases, Web products, and software tools that can be used with HCUP data as well as with other administrative databases to identify, track, analyze, and compare trends in hospital care.

Components of HCUP include the Nationwide Inpatient Sample, the State Inpatient Databases, Quality Indicators Software, as well as HCUPnet, an interactive, Web-based tool for identifying, tracking, analyzing, and comparing statistics on hospitals at the national, regional, and State levels.

Select for more information on HCUP.

Medical Expenditure Panel Survey (MEPS)

MEPS is a nationally representative survey of health care use, expenditures, sources of payment, and insurance coverage for the U.S. civilian noninstitutionalized population, as well as a national survey of nursing homes and their residents. An ongoing survey of about 10,000 households and 24,000 individuals, MEPS provides up-to-date, highly detailed information on how Americans as a whole, as well as different segments of the population, use and pay for health care.

MEPS is used by several Government agencies, including the U.S. Department of Commerce, which uses MEPS data to calculate the health care expenditure component of the Gross Domestic Product.

National Guideline Clearinghouse™ (NGC)

Developed in partnership with the American Medical Association and the American Association of Health Plans, the NGC is a Web-based resource for information on evidence-based clinical practice guidelines. The NGC began providing online access to guidelines at on December 15, 1998. Since becoming fully operational in early 1999, the NGC has had over 2 million visits and now receives over 135,000 visits each month. NGC helps health care professionals and health system leaders select appropriate treatment recommendations by providing full text or an abstract of the recommendations, comparing and evaluating different recommendations, and describing how they were developed.

Evidence-based Practice Centers (EPCs)

AHRQ's 14 Evidence-based Practice Centers conduct systematic, comprehensive analyses and syntheses of the scientific literature to develop evidence reports and technology assessments on clinical topics that are common, expensive, and present challenges to decisionmakers. Since December 1998, over 168 evidence reports and technical reviews have been released.

To ensure that report findings are translated into improvements in clinical practice, AHRQ enlists partners, such as specialty societies and health systems, who use the findings of EPCs to develop tools and materials that will improve the quality of care.

Select for more information on EPCs.

U.S. Preventive Services Task Force (USPSTF)

The USPSTF is an independent panel of preventive health experts, convened by AHRQ, who are charged with evaluating the scientific evidence for the effectiveness of a range of clinical preventive services and producing age-specific and risk factor-specific recommendations for these services. AHRQ provides the technical support for the USPSTF through two of its EPCs and oversees the Put Prevention Into Practice (PPIP) initiative. As the vehicle for implementation of USPSTF recommendations, PPIP provides tools for clinicians and health systems to improve delivery of preventive care.

Select for USPSTF Fact Sheet.

Quality Interagency Coordination (QuIC) Task Force

The QuIC Task Force was established in response to the final report of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. The QuIC's goal is to ensure that all Federal agencies involved in purchasing, providing, researching, or regulating health care services are working in a coordinated way toward the common goal of improving quality of care. AHRQ coordinates QuIC activities for the 12 Federal agencies that comprise this Task Force.

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AHRQ Publication No. 00-P005
Current as of August 2008

Internet Citation:

AHRQ Profile: Quality Research for Quality Healthcare. AHRQ Publication No. 00-P005, August 2008. Agency for Healthcare Research and Quality, Rockville, MD.


AHRQ Advancing Excellence in Health Care