Needs and challenges for health services research at academic health centers.

What are the institutional strategies used by academic health centers and other academic institutions to support and maintain the infrastructure that promotes health services research? Using the findings from interviews conducted in late 1998 with health services researchers at ten health services research centers of several types and from several geographic areas, and with the directors of ten health services research training centers, the authors address this key issue by examining four central infrastructure needs and challenges for health services research: (1) organizing core institutional resources (most centers received some level of core financial support from their parent organizations); (2) supporting career development of individual researchers (the more competitive health care system may diminish the ability of academic health centers and other institutions to give such support, but certain opportunities were noted); (3) supporting and enhancing training in health services research (such support comes from many different disciplines and organizations; the typical career path is in academic settings); and (4) establishing and supporting research partnerships (there are growing opportunities for such alliances). The authors reach a number of conclusions from their study, including the fact that there are a wide variety of models of successful health services research centers, with very different missions, organizational and interdisciplinary configurations, research and policy objectives, and collaborative relationships. Additional studies are needed to further specify those infrastructure elements that foster effective and productive health services research in academic health centers and other university settings.