Oppenheimer C, Gaylin D, Tierney W, Lanier D, Hudson B, Benz J, Zafar A, Finn A; AcademyHealth. Meeting (2004 : San Diego, Calif.).
Abstr AcademyHealth Meet. 2004; 21: abstract no. 1488.
NORC, Health Survey, Program, and Policy Research , 1350 Connecticut Avenue, N.W., Suite 500, Washington, DC 20036 Tel. 202.223.6340 Fax 202.223.6104
RESEARCH OBJECTIVE: Practice-based research networks (PBRNs) are a potential resource for performing relevant research in real-world settings and translating research into everyday practice. Our objective is to describe the universe of primary care PBRNs in the U.S. STUDY DESIGN: Using data collected from a Web-based survey and structured interviews with PBRN directors, we assessed PBRNs' history, size, location, organization, resources, and operations. POPULATION STUDIED: 111 PBRNs composed of primary care practices that aim to perform research and/or translate research into practice were identified through AHRQ'S PBRN initiative, the Robert Wood Johnson Foundation's Prescription for Health program, or through membership in the Federation of PBRNs. PRINCIPAL FINDINGS: 84 (76%) of the 111 PBRNs completed the survey between May and December of 2003. They contain 2724 practices in 44 states and Puerto Rico caring for more than 16 million patients, an average of 198,112 patients per PBRN (range 1200 to 2.7 million). Of the 32 PBRNs with practices in a single primary care specialty, 17 (53%) are family medicine, 10 (31%) pediatrics, and 1 (3%) general internal medicine [GIM]. Of the remaining 52 (62%) with multiple specialties, 51 (98%) had family medicine practices, 39 (75%) pediatrics, and 37 (71%) GIM. PBRN patients tend to be young, 38% are under the age of 18, while only 18% are over 60; 60% of patients are white, 22% black, and 18% other races; 18% are Hispanic. Insurance coverage is 45% private, 42% state/federal, and 13% self-pay. The majority of PBRNs (76%) are affiliated with academic medical centers while 7% are affiliated with professional societies. The average PBRN has been operational for just over four years, with a range of six months to 32 years. A quarter have completed no studies, while nearly half have completed 4 or more. Research is both descriptive (of populations 57%, diseases or treatments 54%, and individual patients 27%), and interventional (28%). The mean number of patients included per study is 1775 (median 888, range 16-20,000). Common research foci of the PBRN include prevention (49%), diabetes (37%), cardiovascular risk (31%), mental health (27%), and cancer (19%). The PBRNs cite funding, community involvement and informatics as areas for improvement, and research experience and administration as strengths. CONCLUSIONS: Primary care PBRNs are large and numerous, but young. Minority and under-insured patients are over-represented. Despite being "practice based," most have ties to academia. Many PBRNs have performed large studies of common primary care issues, and those that have not are in the process of building the infrastructure to do so. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: PBRNs are a potentially rich national resource for innovative, community-based research. PBRNs have the ability to effectively access patient populations, including members of ethnic and racial minorities as well as underserved and urban populations, which are more diverse and geographically representative than individual clinician practices and/or academic medical centers. Gaining stable funding and research experience is the key to their sustainability.
Publication Types:
Keywords:
- Biomedical Research
- Child
- Consumer Participation
- Data Collection
- Ethics Committees, Research
- Family Practice
- Foundations
- Health Services Research
- Humans
- Nursing Research
- Population Groups
- Primary Health Care
- Puerto Rico
- Research
- Research Design
- Research Support as Topic
- economics
- ethics
- hsrmtgs
UI: 103624522
From Meeting Abstracts