The Patient Protection and Affordable Care Act (ACA) is grounded in the goals of increasing access, improving quality, and reducing cost in the U.S. health care system. The ACA established the Patient-Centered Outcomes Research Institute (PCORI) to help accomplish these goals through patient-focused research. PCORI has a different charge than its federally supported counterpart, the National Institutes of Health (NIH)—to fund research that ultimately helps patients make better-informed health care decisions. The authors examined characteristics of the recipients and settings of the first six rounds of PCORI funding and differentiated PCORI and NIH funding patterns to analyze the extent to which PCORI is accomplishing the goals set out by the ACA.
The authors performed a retrospective review of publicly available datasets, supplemented by a short questionnaire to funded PCORI principal investigators (PIs). The authors analyzed PCORI’s first six funding cycles (2011–2014) and data on NIH funding patterns (2000–2013) to determine whether PCORI and NIH funding patterns differed by investigator, department, and institution, and whether PCORI had funded research in primary care settings. The authors found that PCORI is funding a more diverse cadre of PIs and biomedical departments than is NIH, but not a greater diversity of institutions, and that less than one-third of PCORI studies involve or are relevant to primary care—the largest patient care platform in the United States. As PCORI looks to be refunded, it is important that research funding is further evaluated and publicly acknowledged to assess whether goals are being achieved.
S. Mazur is a third-year student, Georgetown University School of Medicine, Washington, DC.
A. Bazemore is director, Robert Graham Center, American Academy of Family Physicians, Washington, DC.
D. Merenstein is research division director, Department of Family Medicine, Georgetown University Medical Center, Washington, DC.
Editor’s Note: This New Conversations contribution is part of the journal’s ongoing conversation on the present and future impacts of current health care reform efforts on medical education, health care delivery, and research at academic health centers, and the effects such reforms might have on the overall health of communities.
A Commentary by J.V. Selby and J.R. Slutsky appears on pages 453–454.
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Funding/Support: The authors would like to thank the Georgetown University School of Medicine Office of Student Research for their financial support of this project.
Other disclosures: None reported.
Ethical approval: This study was reviewed by the institutional review board of the American Academy of Family Physicians and determined not to constitute human subjects research.
Correspondence should be addressed to Daniel J. Merenstein, Georgetown University Medical Center, 4000 Reservoir Rd., NW, Building D 240, Washington, DC 20007; telephone: (202) 687-2745; e-mail: firstname.lastname@example.org.