Investment in Prevention Health Care Delivery Research by the National Institutes of Health

Abstract

Background: Research assessing the delivery of preventive health care has considerable potential for improving health outcomes and reducing health care costs for the United States population. Objective: To characterize the prevention health care delivery research grant portfolio supported by the National Institutes of Health (NIH). Materials and Methods: A random sample of 14,523 NIH research projects funded during 2012–2019 was selected and coded for various study topics using a structured taxonomy. We analyzed the subset of prevention research projects, for which health care delivery was identified as an independent or dependent variable, including study characteristics and funding trends. Results: Overall, 11.2% of NIH-funded prevention research projects were relevant to health care delivery. Of these projects, 68.6% assessed access to care, 53.4% examined quality, and 27.1% assessed costs. Over the study period, the percentage of funded prevention research projects involving health care delivery increased from 10.9%–15.1%. Over half of the projects assessed research related to the prevention of a new health condition, identification of risk factors, or health promotion (55.5%), whereas < half addressed prevention of disease progression/recurrence (40.4%), screening for early disease (20.2%), or screening for risk factors (1.4%). human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use were the most prevalent health topics studied, whereas other topics—such as lung diseases and Alzheimer disease—were less frequently studied. Conclusions: Health care delivery research comprises a modest portion of the NIH prevention research portfolio and is mostly focused on access and quality of care; cost-related analyses are less prevalent. human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use are frequently studied health topics in this portfolio.