Effect of integrated research programs on health care systems and costs

We examined the effect of research program size on clinical costs (current dollars/work unit) and productivity (work units/ employee) in Department of Veterans Affairs (DVA) hospitals. Our data demonstrate that research programs have a small, almost negligible effect on clinical costs. The data also show that average acute medical service length-of-stay was inversely related to research program size. The indirect cost of research may have been almost entirely offset by an increased efficiency, as reflected in the shortened length of stay. This unexpected benefit of research may be due to the influence of research opportunities on the recruitment and retention of highly trained clinicians, including medical specialists. In the past, recruitment and retention was part of the justification for the DVA research program. Although this justification no longer appears to be considered politically acceptable, our data strongly support the notion that research programs can and do enhance the efficiency of medical care. Furthermore, research activities help professional staff maintain their critical thinking and analytic skills. We discuss the implications of these observations on cost containment in health care systems.