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July 11, 2003, Issue No. 104
AHRQ News and Numbers
There were 23,904 cases of hepatitis treated in U.S. community hospitals in 2001. Patients were hospitalized an average of 5.3 days, and total charges averaged $19,003. [Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2001, HCUPnet.]
- AHRQ director testifies on technology, innovation, and the costs of health care before the Joint Economic Committee
- Study links higher physician supply to limits on non-economic damages
- Task Force finds little evidence to support use of vitamins to prevent cancer or heart disease
- Fifth issue of AHRQ WebM&M is available online
- HCUP 2001 Nationwide Inpatient Sample data now available
- 2002 data from MEPS on insurance coverage
- Research on coronary heart disease often doesn't report findings on women
- Free conference call on improving quality of care
- AHRQ in the professional literature
1. AHRQ Director Testifies on Technology, Innovation, and the Costs of Health Care Before the Joint Economic Committee
AHRQ Director Carolyn Clancy, M.D., testified before the Joint Economic Committee on July 9 on "Technology, Innovation, and the Costs of Health Care." Dr. Clancy discussed the important issues of how we can facilitate, sustain, and promote health care innovation while we ensure that we have a health care system that is affordable. She also described five areas in which AHRQ can assist in sorting through the array of new health care innovation and help to speed the adoption of effective interventions. Select to access the testimony.
2. Study Links Higher Physician Supply to Limits on Non-Economic Damages
According to an AHRQ-funded study, states that have enacted limits on non-economic damages in medical malpractice lawsuits have about 12 percent more physicians per capita than states without such a cap. The study is the first of its kind to associate caps on non-economic damages with increased physician supply. It looks at the growth of physician supply since 1970, before any state had enacted caps, and finds that physician supply has grown more in states with caps than in states without caps. Select to access the HHS press release and the study.
3. Task Force Finds Little Evidence to Support Use of Vitamins to Prevent Cancer or Heart Disease
The U.S. Preventive Services Task Force has concluded there is insufficient scientific evidence to recommend vitamin supplements as a way to prevent cancer or heart disease and has recommended against the use of beta carotene supplements in smokers because of a possible increased risk of lung cancer and death. The Task Force conclusions are based on a review of studies on the use of vitamins A, C, or E, multivitamins with folic acid, or antioxidant combinations to reduce the risk for cancer or cardiovascular disease in adults. These findings are published in the July 1 issue of the Annals of Internal Medicine. Select to access the press release and the recommendations.
4. Fifth Issue of AHRQ WebM&M Is Available Online
The fifth issue of the AHRQ WebM&M online patient safety journal is now available. This month's issue features a case of blood thinner mismanagement; a wristband mix-up that resulted in a patient nearly getting the wrong surgery; a child whose eye was mistakenly glued shut with a skin adhesive; and a woman whose adverse reaction to morphine was noticed only when she nearly stopped breathing. This month's Spotlight case describes a patient who requested a "do not resuscitate" order because she misunderstood an inexperienced intern's vague description of resuscitation and suffered a cardiac arrest a few hours after this discussion. The patient's senior resident was faced with proceeding with the resuscitation (potentially violating the patient's wishes) or withholding resuscitation (potentially allowing the patient to die because she misunderstood the implications of the DNR decision). As always, each Spotlight case in accompanied by a slide set that can be downloaded now in a redesigned format. Cases from previous issues are still available under "Past Issues" and "Archives." Select to register to submit cases that encompass the full range of medical errors.
5. HCUP 2001 Nationwide Inpatient Sample Data Now Available
AHRQ's Healthcare Cost & Utilization Project's Nationwide Inpatient Sample (NIS) data from 2001 are now available to the public. The NIS is a unique and powerful database of hospital inpatient stays. Researchers and policymakers use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Select to access the NIS for more information and how to order the data. Selected data from the 2001 NIS also are available on HCUPnet.
6. 2002 Data from MEPS on Insurance Coverage
The number of children covered by public insurance, primarily Medicaid and the State Children's Health Insurance Program, increased by 2.4 million from 2001 to 2002, according to new data from AHRQ's Medical Expenditure Panel Survey. As a result, the percentage of uninsured children fell from 14.6 percent in the first half of 2001 to 12.9 percent of children in the first half of 2002. Overall, in early 2002, 16.4 percent of Americans (46.2 million people) had no health insurance coverage. However, this number is not statistically different from the number of uninsured in the first half of 2001. Select to access the statistical brief (PDF File, 287 KB; PDF Help). The brief also includes graphics representing some of these statistics.
7. Research on Coronary Heart Disease Often Doesn't Report Findings on Women
Two evidence reviews on topics related to coronary heart disease in women, conducted for AHRQ and the NIH Office of Research on Women's Health by researchers at AHRQ's University of California San Francisco/Stanford Evidence-based Practice Center, found that although CHD is the cause of more than 250,000 deaths in women each year, much of the research in the last 20 years has either excluded women or included only limited numbers. As a result, many of the tests and therapies that are used to treat women for CHD are based on studies conducted predominantly in men. HHS has been working to expand the involvement of women in research involving coronary heart disease. For example, the NIH's National Heart, Lung, and Blood Institute supports a wide range of clinical trials on heart disease that have included women, including large studies such as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) and the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM). In addition, the Women's Ischemia Syndrome Evaluation (WISE) study is investigating issues related to the specific symptoms of chest pain in women and the diagnosis of CHD. The NIH also has been working with scientific journals to encourage the publication of more research data specific to women. Select to access the press release. Select to access details of the findings from the two evidence reports, Results of Systematic Review and Systematic Reviews of Evidence on Selected Topics.
8. Free Conference Call on Improving Quality of Care
AHRQ is partnering with CMS in its ongoing efforts to translate research into practice. Findings from an AHRQ-funded study on care for patients with heart attacks will be featured in a national call aimed at quality improvement organizations and hospital administrators. An article based upon the study, which focuses on the roles that senior management plays in improving the quality of clinical care in the hospital setting, was published in the January/February issue of the Journal of Healthcare Management. While the study focused on acute myocardial infarction (AMI), the findings are pertinent to other clinical conditions as well. If you are interested in participating in this free call, scheduled for Thursday, July 31, 2:30-3:30pm EDT. Call the phone number listed and ask to speak with the AMI project manager and find out about how you can reserve a phone line for the call and obtain the materials.
9. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.
Binder EF, Kruse RL, Sherman AK, et al. Predictors of short-term functional decline in survivors of nursing home-acquired lower respiratory tract infection. J Gerontol A Biol Sci Med Sci 2003 Jan;58(1):60-7. Select to access the abstract on PubMed®.
Tallia AF, Stange KC, McDaniel RR Jr, et al. Understanding organizational designs of primary care practices. J Healthc Manag 2003 Jan-Feb;48(1):45-59. Select to access the abstract on PubMed®.
Lee GM, Friedman JF, Ross-Degnan D, et al. Misconceptions about colds and predictors of health service utilization. Pediatrics 2003 Feb;111(2):231-6. Select to access the abstract on PubMed®.
Wagner TH, Jimison HB. Computerized health information and the demand for medical care. Value Health 2003 Jan-Feb;6(1):29-39. Select to access the abstract on PubMed®.
Lautenbach E, Larosa LA, Kasbekar N, et al. Fluoroquinolone utilization in the emergency departments of academic medical centers. Arch Intern Med 2003 Mar 10;163(5):601-5. Select to access the abstract on PubMed®.
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Current as of July 2003