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Performance Budget Submission for Congressional Justification

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Letter from the Director

I am pleased to present the Agency for Healthcare Research and Quality's Fiscal Year 2007 Performance Budget.  We all benefit from safe, effective, and efficient health care.  Our revised performance-based budget demonstrates our continued commitment to assuring sound investments in programs within these three areas that will make a difference in the health care of all Americans.

The Agency's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. In support of this mission, the Agency is committed to improving patient safety by developing successful partnerships and generating the knowledge and tools required for long-term improvement.  Building on past successes, AHRQ continues to use health information technology (HIT) as a strategy to improve patient safety.  We continue to see technologies developed by AHRQ put into practice, providing us with new opportunities to evaluate effective implementation efforts. For example, an insurance company is funding efforts to have software, developed through AHRQ research, installed in hospital intensive care units. In the future, we look forward to expanding our HIT efforts to the primary care setting.

Providing another tool to support patient safety improvement, AHRQ successfully partnered with other organizations to provide hospitals and health systems with a method to perform ongoing evaluations of the safety culture in their facilities. This tool allows health care facilities to continually monitor improvements and make changes to reduce adverse events and prevent patient harm in their organization. Already, this tool has been adopted by organizations like the Veterans Administration, the Department of Defense, and Catholic Health Initiatives, which includes about 70 hospitals.

Section 1013 of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) provided other opportunities for AHRQ to improve patient care. As authorized by MMA, AHRQ initiated a series of state-of-the-science reviews of existing scientific information on the effectiveness and comparative effectiveness of health care interventions, including prescription drugs. These studies focus on 10 top priority conditions affecting Medicare beneficiaries in order to improve the quality, effectiveness, and efficiency of health care delivered through the Medicare program. For example, AHRQ is conducting a science review that examines the effectiveness of older oral drugs versus newer drugs for the initial treatment of diabetes. The combination of explicit reviews of scientific evidence on clinical effectiveness of pharmaceuticals and other health care interventions, and the translation of the findings into meaningful messages, is a critical step in supporting informed decisionmaking.

We are seeing results of efforts to improve quality of care. As mandated by Congress, we released the third annual reports focusing on quality of and disparities in health care in America.  This Quality report demonstrates that we are making strides in improving quality of care.  However, the report also showed that there are still areas in need of major improvements.  For selected aspects of patient safety in hospitals, improvements over 10 percent were found.  In addition, much larger improvements were associated with public reporting efforts by the nation's hospitals and nursing homes.  Alternatively, the Disparities Report indicates that there are pervasive disparities related to race, ethnicity, and socioeconomic status. These important reports serve as new tools for monitoring health care delivery by summarizing information, making clear where improvement is most needed, and facilitating measurement alignment. 

With our continued investment in successful programs that develop useful knowledge and tools, I am confident that we will have more accomplishments to celebrate.  The end result of our research will be measurable improvements in health care in America, gauged in terms of improved quality of life and patient outcomes, lives saved, and value gained for what we spend.  I am proud of our accomplishments to date and look forward to building on our past successes to achieve new gains for the American people. 

—Carolyn M. Clancy, M.D.
Director, Agency for Healthcare Research and Quality

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