This article examines the history of the National Center for Health Services Research (NCHSR) from 1970 to 1976 in terms of the research projects funded, the structural relationships of NCHSR to policy formulation, and the make-up of advisory committees. The analysis of support for research on substantive policy issues indicates that there are no major trends; the variations that do occur can be traced to publicly articulated concerns of Congress or the Executive. On the other hand, there have been major shifts in research strategies. from an early emphasis on large-scale development and demonstration to support for short-term, targeted analytical research. This shift has occurred without a thorough examination of the effectiveness of either strategy for policy-making. The analysis of the structural relationships of the Center do not provide any evidence of a stable, systematic linkage of research and policy-making functions. Nor does the analysis of the various advisory groups show that policy-makers have had a significant involvement in guiding the National Center program.
As a result of these analyses, it is our conclusion that measures need to be taken to provide a systematic, formal linkage of the National Center to health policymakers in the administrative and legislative arms of government. We propose that a National Council for Health Services Research and Policy be instituted for the National Center for Health Services Research to assure accountability in choice of priorities and research strategies, and to provide for policy-maker participation in the program of the agency. The objective of the Council would be to provide timely and comprehensive research information and policy alternatives to appropriate national policy-makers, health care providers and consumers.
