Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

COIN: Center for Health Services Research in Primary Care; Durham, NC

Director: Susan Hastings, MD MHS

About the COIN

This Center's mission is to conduct high-quality research on strategies that enhance the delivery, access, quality, and cost-effectiveness of primary care for Veterans and the VA healthcare system.

Focused Areas of Research

This Center's focused areas of research include:


Transforming Prevention into Action

Patient-Aligned Care Teams (see Transforming Prevention into Action CREATE) are likely to have difficulty providing support for preventive services during traditional one-on-one and face-to-face encounters; therefore, alternative approaches are necessary including:

  • Understanding how best to leverage VA's new web-based health risk assessment information into PACT,
  • Linking Veterans with prevention services,
  • Expanding prevention services to reach more Veterans,
  • Improving effectiveness and efficiency of existing services, and
  • Determining which Veterans are most responsive to effective prevention interventions, in order to customize services.


Chronic Disease Management within Primary Care

Chronic health conditions continue to be the leading causes of death, disability, and healthcare costs within the VA healthcare system. This Center's studies, and other evidence, support the overall effectiveness of chronic disease management interventions within primary care; however, uptake of these interventions has lagged. Projects in this research area will study how to better match Veterans to the types of disease management programs that work best for them, using innovative methods in chronic disease management research. Investigators also will work to:

  • Deliver interventions via mobile health (mHealth) technologies,
  • Identify strategies for helping Veterans maintain treatment gains, and
  • Test methods for referring patients to disease management services.


Advancing the Science for Veterans with Multi-morbidity and Advanced Life-Limiting Illness

Transforming VA primary care for the 21st century requires advancing the science of caring for Veterans with multi-morbidity and advanced life-limiting illness. These conditions are highly prevalent among Veterans, yet research on the effectiveness of interventions and outcomes for these complex patients is scarce. Projects in this research area will test how best to:

  • Train and support caregivers of Veterans with advanced chronic illnesses, and during transitions in care settings;
  • Redesign care to meet the needs of these Veterans in outpatient and acute care settings; and
  • Address methodological challenges of conducting research in these special populations, with high rates of attrition.



Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. This Center's partners include:

  • National Center for Disease Prevention and Health Promotion (NCP): Jane Kim, MD, Acting Chief Consultant for Prevention Medicine
  • VA Mid-Atlantic Health Care Network, VISN 6: Daniel Hoffman, FACHE, Network Director

Related Resources

by Courtney Van Houtven, PhD