Objective: To assess what effect organizational, funding, and system change
s 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, res
earch activities, and indicators of change.
Main Outcome Measures: Percentage of respondents reporting specific percept
ions on (1) how academic and research programs are affected by organization
al changes, (2) availability of research funds, and (3) the overall impact
that health care changes have on research; between-group comparisons on sur
Results: Usable responses were obtained from 138 physicians (response rate,
42.5%). Responding physicians reported workplace changes that included org
anizational restructuring (32.6%), affiliation with managed care plans (24%
), and staff decreases (45.9%). Over half (54.8%) indicated that facility c
hanges had detracted from their abilities to conduct research. A third (34.
8%) reported declines in numbers of inpatient beds, and 89.6% reported decr
eased length of stay (LOS). Decreased LOS was cited as detracting from ongo
ing research by 36.6% and as discouraging new research by 33.3% of responde
nts, Although not reflected in measures of scholarly productivity, 53.6% re
ported having less time to devote to scholarship and 48.5% reported decreas
ed professional activities. Over two thirds (67.4%) of responding physician
s indicated that health care system changes had a negative impact on curren
t 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 o
n rehabilitation physicians' research pursuits.