One important focus of the Patient Protection and Affordable Care Act of 2010 is delivery system reform. The discoveries of basic scientific and clinical research do not help patients unless they are effectively used in the delivery system. This paper addresses two broad questions: What do we need to know about the delivery system to change it in ways that will benefit patients? Where should foundations and funding agencies focus their efforts? The paper suggests four key areas for delivery system research.
Prepared by:
Lawrence P. Casalino, M.D., Ph.D.
Livingston Farrand Associate Professor of Public Health
Chief, Division of Outcomes and Effectiveness Research
Weill Cornell Medical College
Contents
Executive Summary
What Is Delivery System Research?
Conceptual Model
"Long List" of Delivery System Research Areas and Topics
Criteria for Selecting Priority Areas for Delivery System Research
Suggested Key Areas for Delivery System Research
AHRQ's Recent ARRA Comparative Effectiveness Delivery System Initiative
Identifying Key Areas for Delivery System Research
Overview
What Is Delivery System Research?
Conceptual Model
"Long List" of Delivery System Research Areas and Topics
Criteria for Selecting Priority Areas for Delivery System Research
Suggested Key Areas for Delivery System Research
AHRQ'S Recent ARRA Comparative Effectiveness Delivery System Initiative
Conclusion
References
Appendix A: Priority Topics From Institute of Medicine Document
Appendix B: Examples of Some Components of the Conceptual Model in Figure 1
Appendix C: "Long List" of Delivery System Research Areas
Appendix D: Four Suggested Key Areas for Delivery System Research (With Illustrative Studies)
This paper was prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, for presentation and discussion at a meeting on "The Challenge and Promise of Delivery System Research," held in Sterling, VA, on February 16-17, 2011. The findings and conclusions in this paper are those of the author, who is responsible for its content, and do not necessarily represent the views or recommendations of AHRQ. No statement in this paper should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services. The author's contact information follows: Lawrence Casalino, 402 E. 67th Street, New York, NY 10065-6304, (646) 962-8044, lac2021@med.cornell.edu.
