June 25, 2007
HOUSTON – On June 15, 2007, the Department of Veteran Affairs (VA) announced it had renewed funding for the Houston Center for Quality of Care and Utilization Studies (HCQCUS), a VA Health Services Research and Development (HSR&D) Center of Excellence, for another five years.
Founded in 1990, HCQCUS is one of 15 VA-funded centers of excellence in health services research. It is organized into four scientific programs: 1) health decision making and communication, 2) health services delivery and organization; 3) clinical epidemiology and outcomes; and 4) health policy and quality.
"Our goal is to do research that improves how we deliver health care to patients, focusing on veterans. Our society spends billions on biomedical research, but most of those discoveries do not achieve their potential, because they never reach the patient’s bedside or clinic visit," said Laura Petersen, M.D., M.P.H, HCQCUS director. "We seek to ensure biomedical discoveries are translated and applied to patient care, with the ultimate goal of improving health through better health care." Petersen is also a staff physician in the Medical Care Line at the Michael E. DeBakey VA Medical Center and chief of the Health Services Research Section in the Department of Medicine at Baylor College of Medicine.
With 29 investigators and 117 total staff members, the theme of the Center “From Encounter to Policy: An Integrated Approach to Improving Quality of Care for Veterans” targets the continuum of care. In fiscal year 2006, HCQCUS investigators participated in 112 funded projects and published more than 80 manuscripts in peer-reviewed journals. Since the founding of the Houston VA HSR&D Center of Excellence, its investigators have published more than 900 articles in peer-reviewed literature.
Research studies conducted by the Center have impacted and improved patient care and have influenced health policy. In 2003, a study by HCQCUS Associate Director Hashem El-Serag, M.D., M.P.H. reported the number of persons newly diagnosed with hepatocellular carcinoma (liver cancer) was rapidly increasing in the United States. He determined the rates of liver cancer had doubled over the past two decades with the largest increase observed during the 1990s. The study suggested the hepatitis C virus, acquired in the 1960s and 1970s, may be responsible for the increase.
The findings of a study published in 2005 by HCQCUS Investigator Neena Abraham, M.D., M.S. assisted VA policy makers in deciding whether or not they should embrace current recommended guidelines for the safer prescription of non-steroidal anti-inflammatory drugs.
In 2006, HCQCUS Associate Director Mark E. Kunik, M.D., M.P.H. completed a four-year project titled, "A Cognitive-Behavioral Intervention for Depression and Anxiety in Chronic Obstructive Pulmonary Disease." The results of this project supported the development of guidelines for care and education of patients with this disease. A study by Petersen evaluated the scientific evidence for "pay for performance" programs. Her findings were cited extensively in a recent Institute of Medicine report, "Provider Performance: Aligning Incentives in Medicine."
Work by HCQCUS Associate Director Richard Street, Ph.D. and colleagues showed that African Americans are less likely than whites to question their doctors or raise concerns about their care, which may contribute to the racial disparities seen in U.S. health care. This led to the Center's development of the "How to Talk to Your Doctor Program," a community-based education forum to foster patients' adoption of a more active role in encounters with physicians. Center staff have conducted the program in 29 communities with approximately 1,000 participants and trained 97 personnel in Texas.
Research by the VA is a national asset benefiting veteran patients and the entire nation by moving medical science forward. VA investigators played key roles in developing devices and techniques that revolutionized health care such as the cardiac pacemaker, the CAT scan, and liver and kidney transplants. Today, VA is a leader in many areas of research, including AIDS, mental health, heart disease, cancer, diabetes, infectious diseases, and spinal cord injury.
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