AHCPR Makes Available New Grant Funds Under its Small Grants Program

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 organizations.

• 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.

  This research 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.

  This 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 educator intervention.

• Underinsurance and Mortality. Principal investigator: Peter Franks, M.B.B.S., M.S., Highland Hospital of Rochester, Rochester, NY; $66,828; 7/1/97-6/30/98.

  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; $72,974; 6/1/97-5/31/98.

  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 medical consultation.

• Assessing Health Data Needs in a Changing Environment. Principal investigator: William D. White, M.A., Ph.D., University of Illinois, Chicago, IL; $55,758; 6/1/97-5/31/98.

  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; 6/1/97-5/31/98.

  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.

  This 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 outcomes.

• 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 costs.

• 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).