The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services. AHRQ was formerly known as the Agency for Health Care Policy and Research.
Background
AHRQ's Customers
AHRQ's Strategic Goals
The Health Services Research Pipeline
Closing the Gap: From Knowledge to Practice
Impact of AHRQ's User-Driven Research
AHRQ Projects and Quality Improvement Efforts
Mission: To support research designed to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The research sponsored, conducted, and disseminated by the Agency for Healthcare Research and Quality (AHRQ) provides information that helps people make better decisions about health care.
Created: December 1989 as the Agency for Health Care Policy and Research (AHCPR), a Public Health Service agency in the Department of Health and Human Services (HHS). Reporting to the HHS Secretary, the Agency was reauthorized on December 6, 1999, as the Agency for Healthcare Research and Quality.
Sister agencies include the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Care Financing Administration, and the Health Resources and Services Administration.
Budget: $269.9 million. Nearly 80 percent of AHRQ's budget is awarded as grants and contracts to researchers at universities and other research institutions across the country.
Staff: 294
Director: Carolyn Clancy, M.D
Acting Deputy Director: Robert Graham, M.D.
Main functions: AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers—patients and clinicians, health system leaders, purchasers, and policymakers—make more informed decisions and improve the quality of health care services.
AHRQ's strategic goals reflect the needs of its customers. These goals are to:
In addition the 1999 reauthorizing legislation directs AHRQ to:
The Agency achieves its mission through health services research that reflects a pipeline of activities that together build the infrastructure, tools, and knowledge for improvements in the American health care system. The pipeline comprises three critical and interdependent priorities:
Select to access How AHRQ's Research Helps People.
In fiscal year 1999, AHRQ began its Translating Research Into Practice (TRIP) initiative aimed at implementing evidence-based tools and information in diverse health care settings among practitioners caring for diverse populations. In November 1999, the agency awarded its first grants under this initiative, designed to generate new knowledge about approaches which are effective and cost-effective in promoting the utilization of rigorously derived evidence to improve patient care. Currently, 14 TRIP-I studies are underway on topics such as:
In fiscal year 2000, AHRQ released the "Translating Research Into Practice II" Request for Applications. TRIP II focuses on continued development of partnerships between researchers and health care systems and organizations (e.g., integrated health service delivery systems, academic health systems, purchaser groups, managed care programs including health maintenance organizations (HMOs), practice networks, worksite clinics) to help accelerate and magnify the impact of practice-based, patient outcome research in applied settings. Thirteen studies are now underway in response to this initiative.
Select to access TRIP II RFA.
AHRQ's research, data, clinical improvement tools, and quality measurement and improvement tools are used by its customers to enhance the quality of care they provide and purchase and to make more informed health care decisions. Research grants are subject to the same scientific peer review and ranking used by the National Institutes of Health. Examples of intramural and extramural research at work within the Nation's health care system include the following:
Supporting improvements in health outcomes remains one of the Agency's underlying research priorities. AHRQ's outcomes research initiatives, including its Patient Outcomes Research Teams (PORTs), pharmaceutical outcomes projects, and medical effectiveness research, have helped build the science base underlying day-to-day clinical practice and health policy.
For example, findings from AHRQ's stroke PORT led in part to development of guidelines by the American College of Physicians, American Hospital Association, and Joint Council of Vascular Surgeons. Analysis of findings from AHRQ's cataract PORT influenced Blue Cross/Blue Shield plans in two States to change payment policies relating to which patients were most likely to benefit from cataract surgery.
In addition, the VF-14 instrument to measure functional status in patients with cataracts (also developed as part of the cataract PORT):
AHRQ's work in the area of diabetes treatment has led to a collaboration among the Health Care Financing Administration, National Committee for Quality Assurance, American Academy of Family Physicians, American Diabetes Association, and Foundation for Accountability to develop the Diabetes Quality Improvement Project (DQIP). DQIP comprises a set of national diabetes performance measures that will allow for comparisons of quality and stimulate efforts to improve the care for people with diabetes.
Findings from one Agency-supported study showed that blacks are 13 percent less likely to undergo coronary angioplasty and about one-third less likely to undergo bypass surgery than whites. In a study of preschool children hospitalized for asthma, only 7 percent of blacks and 2 percent of Hispanics, compared with 21 percent of whites, were prescribed routine drug treatment to prevent future hospitalizations. According to AHRQ's Medical Expenditure Panel Survey data for children under age 18, Hispanics were nearly 3 times as likely and blacks over twice as likely as whites to lack a usual source of health care.
Researchers investigating these and other issues relating to minority health now have access to a data collection instrument that assesses the interpersonal processes of care from the perspective of minority patients. This instrument was developed with AHRQ support by the Medical Effectiveness Research Center for Diverse Populations at the University of California, San Francisco.
Select for more information about disparities in health care.
AHRQ research has shown that system-level failures led to three-fourths of adverse drug events in the hospital systems the investigators studied. According to another Agency-sponsored study, preventable adverse drug events in a 700-bed teaching hospital accounted for half of the total cost of $5.6 million attributable to such events in 1 year, even though they made up less than a third of the total number of events. As the operating chair of the Quality Interagency Coordination Task Force—the Government-wide collaboration on health care quality issues—AHRQ has coordinated the Federal response to the Institute of Medicine's report on medical errors. In September and November 2000, AHRQ organized meetings involving funding organizations from the public and private sectors to establish a preliminary research agenda on medical errors.
Select for more information on medical errors.
In fiscal year 2001, AHRQ's focus on improving patient safety includes a broad $50 million research initiative that will:
In February 2001, AHRQ issued the third in a series of six requests for applications the Agency expects to issue in fiscal year 2001 as part of its new patient safety and medical errors research program. A new AHRQ priority in fiscal year 2001 will be a focus on the health of workers in the health care field and the quality of the health care workplace. A $10-million appropriation will allow AHRQ to support research on the impact of health care on the well-being and productivity of the Nation's health care workers.
In addition to these projects, AHRQ's major ongoing quality improvement efforts include the following.
The Healthcare Research and Quality Act of 1999 established the Centers for Education and Research on Therapeutics as a permanent program. The purpose of this initiative is to help reduce adverse drug events and promote the safe and effective use of pharmaceuticals by conducting state-of-the-art research that increases awareness of the uses and risks of new drugs and drug combinations, biological products, and devices as well as of mechanisms to improve their safe and effective use. The CERTs initiative was originally established as a short-term demonstration program under the Food and Drug Administration Modernization Act of 1997. AHRQ now supports seven centers under the CERTs program.
Select to access the CERTs Fact Sheet.
CAHPS® is an easy-to-use kit of survey and report tools that provides reliable and valid information to help consumers and purchasers assess and choose among health plans. CAHPS® 2.0 revises the earlier CAHPS® 1.0 questionnaires (English and Spanish versions) and includes a supplemental set of items required for accreditation by the National Committee for Quality Assurance.
CAHPS® incorporates the perspectives of consumers, purchasers, and health plans; can be used to assess both fee-for-service and managed care systems; and applies across commercial, Medicare, and Medicaid populations.
CAHPS® surveys are being used by more than 20 States, 10 employer groups, the Medicare Program, the Federal Employees Health Benefits Program, a wide range of health plans, and a division of Ford Motor Company. More than 93 million Americans now receive information on health plans resulting from CAHPS®.
Select to access more information on CAHPS®.
The most current evidence-based quality measures and measure sets to evaluate and improve the quality of health care are available from the National Quality Measures Clearinghouse™. Select to access more information at: www.qualitymeasures.ahrq.gov
AHRQ sponsors the Healthcare Cost and Utilization Project, a Federal-State-industry partnership to build a multi-State health care data system for research, policy analysis, and quality measurement and improvement. HCUP comprises a family of databases, Web products, and software tools that can be used with HCUP data as well as with other administrative databases to identify, track, analyze, and compare trends in hospital care.
Components of HCUP include the Nationwide Inpatient Sample, the State Inpatient Databases, Quality Indicators Software, Comorbidity Software, and Clinical Classifications Software, as well as HCUPnet, an interactive, Web-based tool for identifying, tracking, analyzing, and comparing statistics on hospitals at the national, regional, and State levels.
Select for more information on HCUP.
MEPS is a nationally representative survey of health care use, expenditures, sources of payment, and insurance coverage for the U.S. civilian noninstitutionalized population, as well as a national survey of nursing homes and their residents. An ongoing survey of about 10,000 households and 24,000 individuals, MEPS provides up-to-date, highly detailed information on how Americans as a whole, as well as different segments of the population, use and pay for health care.
MEPS is used by several Government agencies, including the U.S. Department of Commerce, which uses MEPS data to calculate the health care expenditure component of the Gross Domestic Product.
Developed in partnership with the American Medical Association and the American Association of Health Plans, the NGC is a Web-based resource for information on evidence-based clinical practice guidelines. The NGC began providing online access to guidelines at www.guideline.gov on December 15, 1998. Since becoming fully operational in early 1999, the NGC has had over 2 million visits and now receives over 135,000 visits each month. NGC helps health care professionals and health system leaders select appropriate treatment recommendations by providing full text or an abstract of the recommendations, comparing and evaluating different recommendations, and describing how they were developed.
AHRQ's 12 Evidence-based Practice Centers conduct systematic, comprehensive analyses and syntheses of the scientific literature to develop evidence reports and technology assessments on clinical topics that are common, expensive, and present challenges to decisionmakers. Since December 1998, over 60 evidence reports have been released.
To ensure that report findings are translated into improvements in clinical practice, AHRQ enlists partners, such as specialty societies and health systems, who use the findings of EPCs to develop tools and materials that will improve the quality of care.
Select for more information on EPCs.
The USPSTF is an independent panel of preventive health experts, convened by AHRQ, who are charged with evaluating the scientific evidence for the effectiveness of a range of clinical preventive services and producing age-specific and risk factor-specific recommendations for these services. AHRQ provides the technical support for the USPSTF through two of its EPCs and oversees the Put Prevention Into Practice (PPIP) initiative. As the vehicle for implementation of USPSTF recommendations, PPIP provides tools for clinicians and health systems to improve delivery of preventive care.
Select for USPSTF Fact Sheet.
The QuIC Task Force was established in response to the final report of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. The QuIC's goal is to ensure that all Federal agencies involved in purchasing, providing, researching, or regulating health care services are working in a coordinated way toward the common goal of improving quality of care. AHRQ coordinates QuIC activities for the 12 Federal agencies that comprise this Task Force.
Select for QuIC Web Site.
AHRQ Publication No. 00-P005
Published March 2001
Internet Citation:
AHRQ Profile: Quality Research for Quality Healthcare. AHRQ Publication No. 00-P005, March 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/profile.htm
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