Eric G. Campbell, Ph.D. Institute for Health Policy Harvard Medical School Massachusetts General Hospital The Context of Clinical Research in AHCs: Challenges.

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Presentation transcript:

Eric G. Campbell, Ph.D. Institute for Health Policy Harvard Medical School Massachusetts General Hospital The Context of Clinical Research in AHCs: Challenges and Opportunities

Co-Investigators and Funding David Blumenthal, MD MPP Ernie Moy MD MPH Joel S. Weissman, Ph.D. The Pew Charitable Trusts and The Commonwealth Fund Task Force on Academic Health Centers

The Plan Questions to Answer Methods Results Conclusions

Questions to Answer What is the current state of clinical research in AHCs? What are the current challenges to the clinical research missions of AHCs? What strategic choices are being made at the institutional and department levels to adapt to the challenges in the clinical research environment?

Methods Institutions--U.S. 4 year medical schools Department Chairs –Medicine, Pediatrics, Psychiatry, Neurology, Anesthesiology Senior Research Administrators (SRA) –The senior institutional official, other than the dean, who has primary responsibility for the research activities of the medical school. Associate/Assistant/Vice Dean of/for Research Associate/Assistant/Vice Dean of/for Research Affairs Associate/Assistant/Vice Dean of/for Academic Affairs

Survey Methods 2 survey instruments Cognitive interviews Administered by CSR at UMASS Boston Mixed Mode: Mail and heavy telephone follow-up Results: –65% Overall response rate (n=472 out 712) –66% Chairs response rate (n=390) –65% SRAs response rate (n=82 ) Results published in Aug. 15, 2001 JAMA

Analyses SAS Bivariate –Chi-square Multivariate –Regression adjusted percentages controlling for: Respondent type (SRA v. Chair) Research intensity (NIH Top 50 v. NIH not top 50) MCP (High >40% v. Medium 21%-40% v. Low <20%)

Results Characteristics of Respondents Health and Robustness of Clinical Research Quality Challenges Adaptations

Characteristics of Respondents

Current Health and Robustness

Overall Quality of the Research

Quality of the Research by Research Intensity

Challenges

Challenges to Clinical Research*p<.05

Urgency

Adaptations and Impact

Conclusions Substantial concern over health and robustness of clinical research Similar concern about quality of clinical research Biggest challenges relate to pressures to see patients,lack of clinical revenue and an insufficient supply of clinical research Most frequent adaptations have smallest positive impact