LINKING AUTOMATED DATABASES FOR RESEARCH IN MANAGED CARE SETTINGS

Spurred by demands for data from employer-purchasers and accreditation agencies and the adoption of strategies for disease management and ou tcome-based quality assurance, managed care organizations have recogni zed the need for rapid, convenient access to clinical information. Lar ge investments in administrative and clinical data systems have also p roduced unprecedented opportunities for research on health care and ep idemiology in large, defined populations. There is a long history of c ontributions to research by investigators who are based in the older n onprofit group and staff models of health maintenance organizations (H MOs). Many of these organizations maintain research units that are pri marily funded by outside sources. Research includes descriptive and et iologic studies of epidemiology, randomized and observational studies of the effectiveness of treatment regimens, studies of disease costs a nd estimation of cost-effectiveness, investigations of risk prediction s in populations, of risk and changes in organizational behavior, and evaluations of interventions to alter physician and patient behavior. The work is often conducted in collaboration with academic researchers . The HMO Research Network has recently been established to foster a s cientific exchange among HMO-based researchers. As managed care organi zations come to provide health care coverage to most U.S. citizens, re search conducted by these organizations increasingly overlaps with pub lic health research. Collaboration between HMO-based research centers and researchers from academia and government will undoubtedly continue to increase.