THE COST OF VA-SPONSORED RESEARCH

Background. Under pressures to reduce health care costs, clinical inco me is a shrinking source of support for research. Such pressures also threaten research at the medical centers of the Department of Veterans Affairs (VA). VA research is particularly vulnerable because medical care appropriations constitute a large, though unknown, source of supp ort. This study measures the medical care component and the total of V A research funds. Method. The incremental costs of VA research were es timated from a survey of 497 clinician investigators and data on payro ll, facility costs, and research grants and appropriations. Results. T he incremental costs of VA research totaled $541.4 million in the 1992 -93 fiscal year. This included $245.6 million in federal appropriation s for VA research, $33.1 million in research grants administered by th e VA, and $262.8 million in support from other VA appropriations. Rese arch added as much as $219.8 million to VA patient care costs. Conclus ion. The VA is adopting strategies to increase the internal payoff of its research. The fiscal constraints facing VA and other academic medi cal centers mean that they will be able to support research with their own funds only when it benefits them directly.