I l@ I * t@@l @la@l DRMI" CON'TRACTS FY 1.968 FY 1969 Increase &nd distribution: Continuing Education - Training ...... $1,275,000 $1,325,000 $50,000 Continuing Education - Research ...... 200,000 200,000 ... Operations Research ................... 800,000 850,000 50,000 Development of Standards .......... ;.. 100,000 100,000 ... Planning and Evaluation .............. ... 70 000 702000 Total ......................... 2,375,000 2,545,000 170,000 t,,-nount obligated as of ............. 157-7 Acc6mplishrien'Ls for FY 1968: A. Continuing Education-- 1. short-term trainees - Sixty-two individuals have completed a one-week course in the "Evaluation of Physician Learning" (University of Illinois). Twelve individuals have completed a six-week course in educational science for medicine. 2. One-year fellows - Eight post-doctoral fellows began their fellowship year in September 1967 and will complete their year in 1968. 3. Seven pre-dodtoral fellows began their fellowship year in September 1967. Five of these are writing their Ph.D. dissertations and several of them are expected to move into RIV positions in 1968. The remaining two are expected to continue working toward their Ph.D. with a specialty in educational evaluation in health care settings. Development of Standards - A panel of experts has been assembled to develop iruidelines for judging the _quality of medical facilities equipped and staffed to provide care in the field of cancer. (American College of Surgeons) C. operations Research-- 1. An operational model has been developed of the incidence and recurrence of coronary heart disease, in a form that will facilitate the computation of estimates of the number of requests, day by day and hour by hour, that physicians can be expected to make to admit patients to coronary care units. 2. A linear programming model has been developed of the optimal allocation of the effort of medical personnel between patient care, on the one hand, and on the other hand, the educating of medical personnel so as to increase the future supply of medical personnel of specified capability, the objective being to minimize the discounted future lack of patient care provided. 3. Work is currently in progress on an operational model of a coronary care unit. 4. A model has been developed of rheumatic heart disease, in a form that relates @the possible successful developmental stages of the disease, supported by a statistical representation of the potential morbidity in the population, to the various diagnostic -and therapeutic alternatives, with limited resources, that may be employed regionally in the attempt to control the disease in the population. 5. A series of lectures was given at NIH in the winter and spring, to the sta of the Division, on quantitative methods of representing, analyzing, and evaluating elements of the medical care system, including specifically certain regional types of activities. ,,the above work is being performed by the University of Michigan. &complishments expected in FY 1969: lw A. Operations Research - To develop new knowledge about systems of medical care and new insights into the relationships between the components of those systems, particularly on a regional basis. B. Development of Standards - To develop standards of excellence by which judgments can be made in preparing lists of facilities equipped and staffed to provide the most advanced methods and techniques in the diagnosis and treatment of heart disease, cancer, or stroke, as required by Section 907, P.L. 89-239. 1 C.. Planning and Evaluation - To identify and investigate issues related to future program developments which require analysis and discussion, and to formulate measures @of performance by which regional operations may be measured. Division of Regional Medical Programs 5-Year Plan -- Contracts (In thousands) PPBS Activity 1969 1970 1971 1972 1973 1974 Continuing Education 11 Programmed Research ..... $200 $200 $200 $200 @200 $200 33 Institutional aid, supply ................ 1,325 1,325 1,800 2,300 2,800 3,550 Operations Research 11 Programmed Research .... 850 4,425 5,775 7,000 8,000 9)000 Development of Standards 11 Programmed Research ..... 100 100 100 100 100 100 Re.Rional Health Services 11 Programmed Research ..... ... 500 600 700 700 800 34 institutional aid,, supply ................ ... 100 100 100 .200 200 Planning 71 Planning ...* ............ 35 300 300 400 400 400 Evaluation 72 Evaluation ............... 35 240 250 360 370 380 Total ............................ 2,545 7,190 9,125 11,160 12,770 14,630