title: The cost of VA-sponsored research.
abstract: BACKGROUND
  Under pressures to reduce health care costs, clinical income is a shrinking source of support for research. Such pressures also threaten research at the medical centers of the Department of Veterans Affairs (VA). VA research is particularly vulnerable because medical care appropriations constitute a large, though unknown, source of support. This study measures the medical care component and the total of VA research funds.
  
  
  METHODS
  The incremental costs of VA research were estimated from a survey of 497 clinician investigators and data on payroll, facility costs, and research grants and appropriations.
  
  
  RESULTS
  The incremental costs of VA research totaled $541.4 million in the 1992-93 fiscal year. This included $245.6 million in federal appropriations for VA research, $33.1 million in research grants administered by the VA, and $262.8 million in support from other VA appropriations. Research added as much as $219.8 million to VA patient care costs.
  
  
  CONCLUSIONS
  The VA is adopting strategies to increase the internal payoff of its research. The fiscal constraints facing VA and other academic medical centers mean that they will be able to support research with their own funds only when it benefits them directly.
authors.affiliation: Center for Health Care Evaluation, Veterans Affairs Medical Center, Menlo Park, CA 94025, USA. pbarnett@odd.stanford.edu
authors.forename: P G
authors.initials: PG
authors.lastname: Barnett
authors.forename: A M
authors.initials: AM
authors.lastname: Garber
mesh_terms: D003361:Cost Allocation; D003625:Data Collection; D006787:Hospitals, Veterans / Q000191:economics* / Q000639:trends; D006801:Humans; D012106:Research / Q000191:economics*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics*