The Puerto Rico health care delivery system has experienced dramatic changes over the last 20 years. Amid different reform applications implemented in the past, critical health disparities exist which are intertwined with cost, access and quality issues regarding vulnerable populations. Puerto Ricans in the U.S. also exhibit the worse health status profile of all Latino subpopulation groups. In order to assist decision-makers in evaluating health policy options, it is critical to develop research-based knowledge founded on the reality of the Puerto Rican and U.S. health care systems. Based on this primary need, this application proposes the development of the Puerto Rico Health Services Research Institute (PRHSRI) at the University of Puerto Rico Graduate School of Public Health. It would target the following specific aims that will be completed within a period of three years: 1) establish an administrative structure that will support and foster the development of health services research with emphasis on the area of health disparities; 2) provide methodological and technical support that will facilitate conducting research projects, developing research proposals for external funding and dissemination of research findings; 3) implement a faculty development and mentoring program to enhance the faculty's capabilities to undertake health services research; and 4) conduct pilot projects in health services research that will lead toward more comprehensive research projects through external funding. Research conducted in the island will allow researchers to minimize possible """"""""confounding"""""""" effects of variables studied in the U.S., since language, culture and other environmental factors are controlled for Puerto Ricans living in the island. The long-term objective is to extend the short term pilot projects into more comprehensive comparative studies comparing the health of Puerto Ricans in the island with Puerto Ricans' health in the U.S. The Institute will provide the technical and resource support to promote the development of a research-oriented culture in the Health Services Administration Department.
