The experience of HCSUS has been that it is necessary to involve both physicians in the project leadership and physicians in the community to recruit providers, using a range of incentives that include monetary compensation for their efforts as well as participation as investigators in the project.
To combat this, the HCSUS instrument design task group required research teams to develop research questions and candidate items.
This task group addressed methodological challenges that all research teams face and provided training in these techniques to the HCSUS Research teams.
Clearly, fulfilling this mandate means that even a very large-scale project such as the HCSUS must be able to get out important information quickly and broadly.
We learned a great deal from our efforts in implementing HCSUS that should inform future efforts to conduct a similar study.
When the federal government and the research and policy communities determine that it is important to collect unbiased national data on specific diseases, the paradigm used in HCSUS makes such studies more practical.
However, noting that the HCSUS used less than 3 percent of AHCPR's annual budget at its peak, we believe that there should be room for both kinds of efforts on the national health services research agenda.
The model used by HCSUS does not account for people not receiving care, is quite expensive, and is logistically very challenging.