The effect of changes in the health care environment on rehabilitation research: A survey of rehabilitation physicians

Smith QW, Holcomb JD, Galvin J, DeJong G, DeLisa JA, Roberts JK. The effect of changes in the health care environment on rehabilitation research: a survey of rehabilitation physicians. Arch Phys Med Rehabil 2001;82:1624-9. Objective: To assess what effect organizational, funding, and system changes in the health care environment may have on rehabilitation research. Design: National survey. Setting: Academic and clinical research programs. Participants: A total of 138 physicians participated in the survey. Intervention: Mailed instrument requesting information on demographics, research activities, and indicators of change. Main Outcome Measures: Percentage of respondents reporting specific perceptions on (1) how academic and research programs are affected by organizational changes, (2) availability of research funds, and (3) the overall impact that health care changes have on research; between-group comparisons on survey responses. Results: Usable responses were obtained from 138 physicians (response rate, 42.5%). Responding physicians reported workplace changes that included organizational restructuring (32.6%), affiliation with managed care plans (24%), and staff decreases (45.9%). Over half (54.8%) indicated that facility changes had detracted from their abilities to conduct research. A third (34.8%) reported declines in numbers of inpatient beds, and 89.6% reported decreased length of stay (LOS). Decreased LOS was cited as detracting from ongoing research by 36.6% and as discouraging new research by 33.3% of respondents. Although not reflected in measures of scholarly productivity, 53.6% reported having less time to devote to scholarship and 48.5% reported decreased professional activities. Over two thirds (67.4%) of responding physicians indicated that health care system changes had a negative impact on current research, and 54.5% indicated that such changes made it less likely that they would pursue new research. Conclusion: Changes in the health care system have had a dampening effect on rehabilitation physicians' research pursuits. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation