The Agency for Healthcare Policy and Research

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The Agency for Health Care Policy and Research (AHCPR) is the newest of the eight agencies in the United States Public Health Service. It was established in 1989 to improve the quality, appropriateness, and effectiveness of healthcare services. Although its budget is relatively small, $128.5 million this year, AHCPR promises to play an increasingly important role in quality of care issues. AHCPR is not involved directly in surveillance or epidemiology, but provides funding for researchers involved in such projects. Further, AHCPR is developing guidelines to improve quality of care; many such guidelines should have a major impact on hospital quality management (QM) projects. Perhaps the most visible component of AHCPR is the Office of the Forum for Quality and Effectiveness in Healthcare. This office convenes panels of healthcare experts to develop guidelines, or it conaaitracts with public and private nonprofit organizations to do so. The AHCPR began developing guidelines because research has identified major variations in the way physicians care for specific medical problems. Dramatic differences have been found among neighboring communities in rate of hysterectomies, prostatectomies, and tonsillectomies, for example. These differences have raised concern that healthcare dollars are wasted on ineffective or inappropriate care. In response, the AHCPR is developing guidelines in areas of medicine where there is no strong consensus among physicians about what works best and for whom. AHCPR considers a number of factors in selecting guideline topics, including: Adequacy of science-based evidence. Number of individuals affected by the clinical condition.