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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Introduction to Health Services Research : A Self-Study Course

Module 2: Brief History of Health Services Research (Page 23 of 40)

Cost Control Efforts Increase

While the researchers of the 1960s focused on the socioeconomic disparities of people using health care, the increases in health care costs attributed to Medicare and Medicaid expenditures pushed the issues of cost control to the forefront of the research agenda.

Urban Institute Established by President Johnson

The Johnson Administration established the Urban Institute (Web site) in 1968 to evaluate the programs of the Great Society (by studying America's cities and urban populations).

Health Care Financing Administration (HCFA)

The Health Care Financing Administration, established in 1974, managed the Medicare and Medicaid programs and generated research on their effectiveness and quality (Berman, 1990).

The Agency started demonstration projects to examine enrollment, payment, benefit design, and other issues involved in extending HMO coverage to Medicare beneficiaries. HCFA's large, national datasets on medical care utilization gave new impetus to health services research.

These earlier attempts at effectiveness research have continued into the present as health technology assessment studies and practice guidelines development (de Lew, 1992).

HCFA later became the Centers for Medicare and Medicaid Services (CMS). Additional information on CMS is available in Module 3.

National Center for Health Statistics (NCHS)

The National Center for Health Statistics (NCHS) was formed in 1960 through the merger of the National Office of Vital Statistics and the National Health Survey. Since 1987, NCHS has been a part of the Centers for Disease Control and Prevention (CDC).

Its purpose is to collect statistics on the health of the population of the United States including illness and disability, environmental, social, and other health hazards, determinants of health, health resources, utilization of health care, health care costs and financing, and family formation, growth, and dissolution.

Health, United States Appears

In 1976 the first edition of Health, United States was published with data from 1975 and earlier. It appeared in three major sections:Cover of Health, United States, 2005 (but link may go to more recent issues). This image opens in a new window. Close the window to return to this page.

  • Part A: Financial Aspects of the Nation’s Health Care
  • Part B: Health Resources
  • Parts C and D: Health Status and Use of Health Services

(Note: Health, United States, 1976, is a large file and may freeze your computer if you try to download it. More recent issues may be downloaded as one PDF document or by individual section/appendix).

Data for some tables in the first issue of Health, United States are available back to 1929.

Find out more about NCHS in Module 3.

VA - Health Services Research and Development

In 1973 the Veteran's Administration set up a Health Services Research and Development section to do research and incorporate that research into practice. HSR&D currently supports five types of research centers: Centers of Excellence (CoEs), Research Enhancement Award Programs (REAPs), Targeted Research Enhancement Programs (TREPs), Resource Centers, and Quality Enhancement Research Initiative (QUERI) Coordinating Centers.

Additional information on VA Health Services Research and Development is available in Module 3.

View Key Projects and Milestones in Health Services Research.

Discussion Questions

  1. How important are the CMS (previously HCFA) datasets for health services researchers? What about the already processed data in the form of charts and tables? Does anyone besides researchers use CMS data? Who?
  2. Describe some of the current research on health technology assessment and practice guidelines development. Why would CMS be interested in funding research on health technology assessment and practice guidelines development?
  3. Discuss why Health, United States is such an important document for health services librarians.
  4. Do you ever look at the VA-HSR&D site? What research and other content does it provide that might be of interest to your clients? Cite a recent study that is of interest.
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