Major federal program to provide better health care, underfunding of primary care

Despite the mandate to help patients make more informed decisions about health care, a ten-year research program established under the Affordable Care Act funded a number of relatively small number of studies devoted to primary care, the setting in which the majority of patients receive treatment.

The discovery, reported in the Journal of General Internal Medicine, found that only about a quarter of the 250 trials funded between 2015 and 2018 by the Center for Patient-Centered Outcome Research (PCORI) had any link to the primary care setting. The rest was dedicated to specialized care.

In addition, only about 30% of the $ 1.17 billion spent on research could be applied to primary care patients, says lead researcher Dan Merenstein, MD, professor of medicine and director of programs. of research at the Department of Family Medicine at Georgetown University. Medicine School.

"If the mission is to help patients solve the problems that affect them the most, PCORI is injecting substantial subsidies where they should not be," Merenstein said. "The program, which needs to be renewed and could be dissolved in 2020 with grants in excess of $ 3.5 billion, is very disappointing for physicians who are dedicated and believe strongly in primary care.We should be at the front -guard of these searches. "

Merenstein and his collaborators, all present in Georgetown at the start of the study, pointed out in their first study, published in 2016, that a review of 300 grants worth $ 400 million, granted between 2011 and 2014, had revealed that between 19 and 32% on primary care.

This latest study examines grants awarded between 2015 and 2018 and found no change.

This new study is "stronger in that if it had a chance to affect primary care patients, we counted it as primary care," Merenstein said.

PCORI is an independent, non-profit, non-governmental organization authorized by Congress in 2010.

"It is in a unique position to impact on patient health, especially in the context of primary care.Most health care is accessible through primary care, making it an ideal environment for research. that will have an impact on the patient's healthcare experience, "said first author, Andrew Blaster, a medical student in Georgetown. coauthor