Using Health Care Utilization and Publication Patterns to Characterize the Research Portfolio and to Plan Future Research Investments

PLoS One. 2014 Dec 10;9(12):e114873. doi: 10.1371/journal.pone.0114873. eCollection 2014.

Abstract

Objective: Government funders of biomedical research are under increasing pressure to demonstrate societal benefits of their investments. A number of published studies attempted to correlate research funding levels with the societal burden for various diseases, with mixed results. We examined whether research funded by the Department of Veterans Affairs (VA) is well aligned with current and projected veterans' health needs. The organizational structure of the VA makes it a particularly suitable setting for examining these questions.

Methods: We used the publication patterns and dollar expenditures of VA-funded researchers to characterize the VA research portfolio by disease. We used health care utilization data from the VA for the same diseases to define veterans' health needs. We then measured the level of correlation between the two and identified disease groups that were under- or over-represented in the research portfolio relative to disease expenditures. Finally, we used historic health care utilization trends combined with demographic projections to identify diseases and conditions that are increasing in costs and/or patient volume and consequently represent potential targets for future research investments.

Results: We found a significant correlation between research volume/expenditures and health utilization. Some disease groups were slightly under- or over-represented, but these deviations were relatively small. Diseases and conditions with the increasing utilization trend at the VA included hypertension, hypercholesterolemia, diabetes, hearing loss, sleeping disorders, complications of pregnancy, and several mental disorders.

Conclusions: Research investments at the VA are well aligned with veteran health needs. The VA can continue to meet these needs by supporting research on the diseases and conditions with a growing number of patients, costs of care, or both. Our approach can be used by other funders of disease research to characterize their portfolios and to plan research investments.

MeSH terms

  • Aged
  • Biomedical Research / organization & administration*
  • Biomedical Research / trends
  • Cost of Illness
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Financing, Government / organization & administration
  • Financing, Government / trends
  • Forecasting
  • Humans
  • Male
  • Publications / statistics & numerical data
  • Research Support as Topic* / economics
  • Research Support as Topic* / organization & administration
  • Research Support as Topic* / trends
  • United States
  • United States Department of Veterans Affairs / economics
  • United States Department of Veterans Affairs / organization & administration
  • United States Department of Veterans Affairs / statistics & numerical data

Grants and funding

The study was supported by contract #GS-10F-0086K/V101-G-17108 with the Department of Veterans Affairs. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Co-authors Luba Katz, Rebecca V. Fink and Samuel R. Bozeman are employed by Abt Associates Inc. Abt Associates Inc. provided support in the form of salaries for authors Luba Katz, Rebecca V. Fink and Samuel R. Bozeman, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.