Every day, healthcare organizations, providers, and other stakeholders face crucial decisions about how to improve the delivery and equitability of care, but they often lack critical information needed to guide them. Patient-centered comparative clinical effectiveness research (CER) can generate evidence that patients, caregivers, clinicians, healthcare systems leaders, and other stakeholders can use to make informed choices about their health and health care.

Addressing Disparities and Improving Healthcare Systems are two of PCORI’s five National Priorities for Research. These priorities come together in the Healthcare Delivery and Disparities Research (HDDR) program, which focuses on comparing patient-centered approaches to improve the equitability, effectiveness, and efficiency of care. The program manages research studies related to these two priorities that will provide valuable knowledge to patients and others in the healthcare community.

Improving Healthcare Systems

Healthcare systems encompass multiple levels (e.g., national, state, and local; organization or practice settings; family and social supports; and the individual patient) and include entities organized to deliver, organize, purchase, or coordinate healthcare services. Our HDDR program manages studies that compare the clinical effectiveness of alternative features of these systems to see which can best improve the quality, outcomes, and efficiency of care for patients and have the most potential to be taken up by others across healthcare system over time and resulted in sustained impacts on patient outcomes. Examples include innovative technologies, workforce issues, incentive structures, and service designs.

Addressing Disparities

Our HDDR program pays particular attention to a subset of PCORI’s populations of interest for which there is either strong evidence for health and healthcare disparities or insufficient health data. These groups are racial and ethnic minorities; rural populations; people with low incomes or low socioeconomic status; individuals with disabilities; lesbian, gay, bisexual, and transgender communities; and people with limited English proficiency. We encourage the research community to conduct patient-centered studies that go beyond describing disparities in health and health care. Rather, we seek evidence through comparing clinical and healthcare system interventions to help guide decisions about how to eliminate disparities.


Posted: March 29, 2017

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