The Division of Health Services Research

The Division of Health Services Research assesses the organization, financing, and delivery of health care and provides support for investigators working in health services research. Linkages between policy, practice and research highlight the Division of Health Services Research's vision statement:

The Division of Health Services Research conducts nationally recognized research that fosters and supports policy and improves health care education and practices.

Health services research is “the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communities, and populations.” (p. 8; Lohr & Steinwachs, 2002).

Our Mission
The mission of the Division of Health Services Research is to implement and complete multidisciplinary investigations that examine health care access, quality, cost, and outcomes and emphasize applications to education, policy, and practice.

The Division of Health Services Research serves as a home for health services research within Oregon Health and Science University. We have a strong portfolio of research that examines the organization, delivery and financing of services for alcohol, drug and mental health disorders and the outcomes of those services. A focus on the nexus of policy, practice, and research characterizes much of the work; investigators collaborate with practitioners to assess the impacts of organizational change, implementation of evidence-based practices, and promote the adoption of evidence-based practices.

Faculty & Research Associates

The current portfolio of research, education, and service funding reflects interests in benefit design for public health care, purchasing in public benefit programs, care for alcohol and drug disorders and recovery from serious mental illness:

Research

• Oregon/Hawaii Node of the National Drug Abuse Treatment Clinical Trials Network works with treatment programs in Oregon and Hawaii to implement clinical trials that test emerging drug abuse treatments in real world settings.
• ADAPT ( Roseburg),
• ChangePoint ( Beaverton, Portland, and Vancouver, Washington),
• CODA ( Portland),
• Kaiser Permanente Hawaii Behavioral Health Services ( Honolulu)
• Kaiser Permanente Northwest Department of Addiction Medicine ( Portland, Salem and Vancouver, Washington),
• Native American Rehabilitation Association ( Portland)
• New Directions Northwest ( Baker City), and
• Willamette Family (Eugene)

Studies examine opioid detoxification using buprenorphine, motivational interviewing to facilitate treatment engagement and retention, motivational effectiveness treatment for Spanish speaking individuals, HIV and HCV services within substance abuse treatment, techniques to reduce HIV risks among injection drug users, and the addition of vocational counseling to outpatient services. The Oregon Node is one of 17 Nodes. See the NIDA web site for more information (http://www.drugabuse.gov/CTN/Index.htm). Funding from the National Institute on Drug Abuse.

• Evaluation of the Network for the Improvement of Addiction Treatment (NIATx) examines a Robert Wood Johnson Foundation program (Paths to Recovery) and a companion program from the Center for Substance Abuse Treatment (Strengthening Treatment Access and Retention). The initiatives work with almost 50 treatment centers across the nations and use process improvement techniques to increase access to substance abuse treatment and enhance retention in care. OHSU is responsible for quantitative and qualitative assessments of program impacts and effects. Funding from the Robert Wood Johnson Foundation, the Center for Substance Abuse Treatment (through a subcontract from Northrop Grumman Corporation), and the National Institute on Drug Abuse.
• Adoption of buprenorphine within an HMO setting explores the impact of buprenorphine on treatment for opiate dependent individuals in two health plans. Administrative data and interviews with patients and staff will be used to assess the cost and utilization of services. Funding from the National Institute on Drug Abuse.
• Oregon Senate Bill 267 and the adoption of evidence-based practices monitors the implementation of legislative requirements to purchase evidence-based practices for substance abuse treatment. Funding from the Robert Wood Johnson Foundation through the Substance Abuse Policy Research Program.

Other Recent and Current Awards

• Oregon Office of Mental Health and Addiction Services
  • An evaluation of the data collection and consultation process the state uses to assess treatment effectiveness and provide quality improvement assistance for agencies receiving funds from the State to provide treatment to Oregon residents.
  • Supported a review of services at the Oregon State Hospital.
• National Institute on Alcohol Abuse and Alcoholism.
  • Gender, Drinking Patterns, Health & Service Seeking assesses how and why gender differences in drinking patterns and other health-related practices affect willingness to use different types of health care services.
  • Managed Care and the Evolution of Outpatient Services surveyed outpatient alcohol and drug abuse treatment programs in six New England States and assessed changes in the organization and delivery of care over a five year period.
  • Implementation of MET/CBT 5 in nine CSAT grantees.
• National Institute on Drug Abuse
  • Client and Counselor Attitudes Toward the Use of Medications examines attitudinal and social normative influences on the use of medications to treat heroin dependence. The study provides insights into strategies to facilitate technology transfer and to promote the use of pharmacotherapy for treatment of alcohol and drug disorders.
  • Elimination of Methadone Benefits in the Oregon Health Plan: Patient Impacts. This investigation documents the impact of benefits reduction on methadone clients’ drug use, legal problems, employment status, use of services, psychiatric health living conditions and other risk behaviors. Findings have public health, economic, and policy impacts.
  • Adoption of Buprenorphine in an HMO Setting examines treatment for opioid dependence in a large health plan.

Education

• Northwest Frontier Addiction Technology Transfer Center (NFATTC) began in 1993 as a resource and catalyst for system development within the Northwest and Pacific region’s addiction education, treatment and policy-making community. The project serves five states (AK, HI, ID, OR, & WA) and the U.S. affiliated Pacific Island Jurisdictions. The ATTC Network includes 14 independent Regional Centers and a National Office. Each ATTC strives a) to increase the knowledge and skills of addiction treatment practitioners from multiple disciplines by facilitating access to state-of-the-art research and education; b) to heighten the awareness, knowledge, and skills of all professionals who have the opportunity to intervene in the lives of people with substance use disorders; and c) to foster regional and national alliances among practitioners, researchers, policy makers, funders, and consumers that support implementation of best treatment practices. A website (http://www.nfattc.org/NFATTCinfo.htm) provides more details. Funding from the Center For Substance Abuse Treatment.

Links of Interest

Oregon Office of Mental Health and Addiction Services

National Institute on Alcohol Abuse and Alcoholism

National Institute on Drug Abuse

Northwest Frontier Addiction Technology Transfer Center (NFATTC)

Oregon/Hawaii Node of the National Drug Abuse Treatment Clinical Trials Network (ORNODE)

OHSU Center for Substance Abuse Policy and Research (CSAPR)