Market forces and unsponsored research in academic health centers

Context Increased competitive pressures on academic health centers may resu lt in reduced discretionary funds from patient care revenues to support the performance of unsponsored research, including institutionally funded and faculty-supported activities. Objective To measure the amount and distribution of unsponsored research ac tivities and their outcomes. Design and Setting Survey conducted in academic year 1996-1997 of 2336 rese arch faculty in 117 medical schools. Responses were weighted to provide nat ional estimates. Main Outcome Measures Institutionally funded research as a proportion of to tal direct costs of research was compared across stages of market competiti on. Logistic regression was used to assess the relationship of performing u nsponsored research to faculty characteristics and market stage. Results Overall, 43% of faculty received institutional funding for research . Young faculty were more likely than others to receive institutional suppo rt (adjusted odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.9; P = .004). The amount of institutional support as a proportion of total fund ing was more than twice as high in less competitive markets (6.1 %) compare d with the most competitive markets (2.5%; P = .05). Most faculty (55%) per formed faculty-supported research. Clinical researchers (OR, 1.6; 95% CI, 1 .1-2.3), principal investigators (OR, 4.3; 95% CI, 2.8-7.0), faculty with h igh levels of research effort (OR, 6.2; 95% CI, 4.0-9.5) or institutional f unding (OR, 1.9; 95% CI, 1.4-2.6), and faculty in the most competitive mark ets (OR, 1.9; 95% CI, 1.4-2.5) were more likely than others to conduct facu lty-supported research. When undertaken by clinical researchers, these acti vities were supported by clinical income, extra hours worked, and discretio nary funds, and often led to publications (76%) or grant awards (51%). Conclusions Many academic health center faculty receive institutional suppo rt to conduct their research or fund the research themselves. Market pressu res may be affecting the level of institutional funding available to facult y.