AMA Resolutions

Resolution: X (A-02)

Introduced by:  American College of Preventive Medicine

Subject:    Funding for the Agency for Healthcare Research
                and Quality

Referred to:  Reference Committee __

Whereas, it is the mission of the Agency for Healthcare Research and Quality (AHRQ), as the health services research arm of the U.S. Department of Health and Human Services,

to provide evidence-based information on health care outcomes, quality, cost, use, and access; and

Whereas, AHRQ evaluates the effectiveness and efficiency of different approaches for financing, organizing, and delivering health care services; and

Whereas, AHRQ conducts and funds essential primary care and clinical prevention research and plays an essential role in identifying ways to eliminate racial and ethnic disparities; and

Whereas, the AMA has demonstrated considerable commitment to health services research, patient safety initiatives, improved therapeutic approaches, and prevention (H-460.926, H-460.999, and H-335.965); and

Whereas, our AMA, in partnership with AHRQ and the American Association of Health Plans, sponsors the National Guidelines Clearinghouse—an Internet-based repository of evidence-based clinical practice guidelines that has provided a practical tool for implementing evidence-based medicine to thousands of physicians in the U.S. and around the world; and

Whereas, according to Clinical Research: A National Call to Action (AMA, AAMC, November 1999), there is insufficient funding for certain types of clinical research—such as research on clinical knowledge, diagnosis, the natural history of disease, primary and secondary prevention and health promotion, health services research, epidemiology, and community-based health issues; and

Whereas, according to the Report of the Graylyn Consensus Development Conference (AMA, AAMC, November 1998), AHRQ historically has been under funded; and

Whereas, the Administration's FY 2003 proposed budget calls for a $48 million cut to the agency; and

Whereas, the proposed decrease would force AHRQ to reduce current grant commitments by 46 percent and contract commitments by 31 percent, preclude it from funding any new non-patient safety grants in FY 2003, and significantly reduce the budget for the National Guidelines Clearinghouse; and

Whereas, the AMA is a member of the Friends of AHRQ coalition, and the Friends of AHRQ have agreed to request $390 million for AHRQ in FY2003; therefore be it

RESOLVED, that our AMA shall send a letter to all members of the House and Senate Appropriations Committees by June 30, 2002, urging support for the Agency for Healthcare Research and Quality (AHRQ) in FY 2003 appropriations at the level requested by the Friends of AHRQ coalition ($390 million).

H-460.926 Funding of Biomedical, Translational, and Clinical Research

Our AMA: (1) reaffirms its long-standing support for ample federal funding of medical research, including basic biomedical research, translational research, clinical research and clinical trials, health services research, outcomes research, and prevention research; (2) encourages the National Institutes of Health, the Agency for Healthcare Research and Quality and other appropriate bodies to develop a mechanism for the continued funding of translational research; and (3) continues to support efforts by Research!America and others to double the current federal medical research budget by the year 2002. (Sub. Res. 507, I-97; Reaffirmed: CSA Rep. 13, I-99; Modified: Res. 503, and Reaffirmation A-00)

H-460.999 Support of Continued Government Funding for Basic and Applied Clinical Research

Our AMA (1) reaffirms its interest in promoting research; and (2) supports restoration and continuation of government funds for basic and applied clinical research. (Res. 8, A-71; Reaffirmed: CLRPD Rep. C, A-89; Reaffirmed: CSA Rep. 13, Sunset Report, and Reaffirmation A-00)

H-335.965 Patient Safety

Our AMA: (1) continues its advocacy efforts in the area of patient safety and work to promote a meaningful long-term approach to ensure greater patient safety in the delivery of health care in our nation;

(2) will work in collaboration with the National Patient Safety Foundation, national medical specialty societies, state and local medical societies, other provider groups and a broad range of public and private organizations to continually advance efforts to improve patient safety through educational activities and all other available means to discover and promote "best practices" in the delivery of health care services;

(3) continues to advance non-punitive, evidenced-based health systems error data collection as well as strong legal protections for participants in safety programs. At a minimum, these protections must ensure that all information reported or otherwise gathered in the process of patient safety and error reporting programs (including any data, report, memorandum, analysis, statement, or other communication) intended either for internal use, or to be shared with others solely for the same purposes, remain confidential and not be subject to discovery in legal proceedings. Such protections must extend from the time of reporting to post-incident review activities and with regard to the repositories of identifiable data from such reporting programs;

(4) continues to call for a central role for the Agency for Healthcare Research and Quality (AHRQ) in coordinating the multifaceted, multi-industry national patient safety initiative envisioned by the AMA. The AHRQ must have sufficient funding to carry out research and development activities to support and advance public and private patient safety initiatives across the nation; and

(5) continues to help us inform our patients and the public in general concerning on-going efforts to improve quality and reduce errors in medical care. (Sub. Res. 202, A-00; Reaffirmed: BOT Rep. 13, I-00; Reaffirmation A-01)