AHCPR and the changing politics of health services research.
The Agency for Health Care Policy and Research has had a turbulent history. Created with little opposition in 1989, it narrowly escaped being eliminated in 1995, only to be reauthorized (with a new mandate and name--the Agency for Healthcare Research and Quality, or AHRQ) with overwhelming support in 1999. In focusing on budgetary history, this paper sheds light on why health services research (HSR) has difficulty obtaining funding from a government that is willing to spend vast sums on basic biomedical research. The paper argues that three strategies--bureaucratic, marketing, and constituency building--that advocates adopted in the late 1980s made HSR more visible and consequential and were responsible for AHCPR's budgetary successes as well as its near-demise.
Gray
Bradford H
BH
Division of Health and Science Policy, New York Academy of Medicine, USA.
Gusmano
Michael K
MK
Collins
Sara R
SR
D002017:Budgets; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006302:Health Services Research; D006801:Humans; D011057:Politics; D011641:Public Relations; D012109:Research Support as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality / Q000191:economics / Q000458:organization & administration*