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September 26, 2003, Issue No. 110
AHRQ News and Numbers
About 17.3 percent of employees enrolled in health insurance in 2001 chose employee-plus-one coverage, which is for couples or a single parent with one child. The average health insurance premium in 2001 for employee-plus-one coverage was $5,463, and the average employee contribution was $1,070. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #23, Employer-Sponsored Single, Employee-Plus-One and Family Health Insurance Coverage: Selection and Cost, 2001. (PDF File, 161 KB; PDF Help)]
- Delays in grant application submission due to Hurricane Isabel
- AHRQ article in JAMA on effect of ethics consultations for dying patients
- Updated AHRQ policy on minority supplemental awards to grants
- Take a Loved One to the Doctor Day a success
- AHRQ unveils new data books and online tool to help monitor the nation's health care safety net
- Guidelines added to the National Guideline Clearinghouse™
- Highlights from our monthly newsletter
- AHRQ in the professional literature
1. Delays in Grant Application Submission Due to Hurricane Isabel
Hurricane Isabel led to the closure of institutions on the east coast and the Federal Government in the Washington, DC area. AHRQ realizes that this may cause problems for investigators who are planning to submit grant applications. Applications that are submitted late because of problems caused by Hurricane Isabel should include a cover letter noting the reasons for the delay. It is not necessary to get permission in advance for hurricane-related delays in grant application submission, but it is expected that the delay generally will not exceed the time period that an institution was closed. Select to access the notice in the NIH Guide.
2. AHRQ Article in JAMA on Effect of Ethics Consultations for Dying Patients
A new AHRQ-funded study found that consultations by specialists to help resolve ethical conflicts resulted in a significant reduction in life-sustaining treatments that were highly unlikely to be beneficial to dying patients. Lawrence J. Schneiderman, M.D., and his colleagues at the University of California, San Diego, carried out a randomized controlled trial involving seven U.S. hospitals offering ethics counseling to dying patients who were involved in conflicts with family members or their health care team over the course of their treatment. The study found that patients who received counseling and died before discharge spent 3 fewer days in the hospital and nearly 1.5 fewer days in ICUs, as well as 2 fewer days receiving life-sustaining treatments such as mechanical ventilation. The authors emphasized that this earlier withdrawal of treatments and transfers out of ICUs did not result in any difference in overall mortality between the patients offered the ethics consultation and the control patients. The study, "Effect of Ethics Consultations on Nonbeneficial Life-Sustaining Treatments in the Intensive Care Setting: A Randomized Controlled Trial," was published in the September 3 issue of JAMA. Select to access the abstract on PubMed®.
3. Updated AHRQ Policy on Minority Supplemental Awards to Grants
AHRQ is updating its policy on minority supplement awards. A minority supplement is a type of program expansion supplement in which the program goals are to increase the number of minority health services researchers and to expand research on topics relevant to minority health. This policy update complies with the fundamental principle underlying the distribution of all Federal research grant funding, which is to ensure that competition for grant funds is as open as possible. Select to access the notice in the NIH Guide.
4. Take a Loved One to the Doctor Day a Success
Preliminary HHS reports indicate that the September 16 Take A Loved One to the Doctor Day, the HHS public-private partnership to promote good health in minority populations, was again successful. This year's campaign, while primarily targeting African Americans and Hispanics, also reached out to Asian American and Pacific Islander, American Indian and Alaska Native populations. More than 450 national, state and local organizations representing 50 states, District of Columbia, and Puerto Rico, planned health activities in more than 200 communities nationwide. In the weeks leading up to the event, the ABC Radio Networks and Radio Unica aired health messages in English and Spanish, respectively, to encourage listeners to make appointments with health care providers for themselves and for loved ones and to promote HHS resources available to the public. ABC radio personality Tom Joyner dedicated his national 4-hour morning show on September 16 to relay the importance of prevention and early detection of diseases that affect minorities at disproportionate rates, provide health information with entertainment, and air live interviews from Secretary Thompson and Deputy Secretary Claude Allen, businessman Magic Johnson, and other important community leaders. Television coverage included Telemundo and Univision in some locations. HHS officials visiting health events in communities and health centers around the country included Deputy Secretary Claude Allen, Surgeon General Richard Carmona, Deputy Surgeon General Kenneth Moritsugu, Assistant Secretary for Aging Josephina Carbonell, and Deputy Assistant Secretary for Minority Health Nathan Stinson. Free health screenings and materials for consumers such as AHRQ's Quick Tips—When Talking with Your Doctor and the men's and women's Checklist for Your Next Checkup brochures were provided. More importantly, many people in need of health care were screened and connected with local health services, some for the first time in years.
5. AHRQ Unveils New Data Books and Online Tool to Help Monitor the Nation's Health Care Safety Net
AHRQ this week announced the availability of two new data books and an online safety net profile tool to help improve the monitoring of the nation's health care safety net. The nation's safety net system of providing health care to low-income and other vulnerable populations was described as "intact but endangered" in a report released by the IOM in 2000, leading AHRQ and HRSA to create a joint safety net monitoring initiative and develop the new products. The free data books and online tool are available on the Web site or by sending an E-mail to AHRQPubs@ahrq.hhs.gov. The site also includes a fact sheet, electronic data sets and documentation, and frequently asked questions. To enable state and local officials to measure key indicators of the safety net in their jurisdictions, a tool kit of nine commissioned papers will complement the data sources. Two papers are currently available on the site; the full tool kit will be available later this Fall.
6. Guidelines Added to the National Guideline Clearinghouse™
To see what's new at the National Guideline Clearinghouse™ (NGC)—a public resource for evidence-based clinical practice guidelines—select What's New. To subscribe to the NGC Weekly Update Service, which notifies you via E-mail when new features and guidelines become available at the NGC Web site, select registration. AHRQ also has available a supply of NGC tutorials on CD-ROM. The tutorial walks you through a series of informative demonstrations and scenarios on using the NGC. The CD-ROM is available free of charge by calling the AHRQ Publications Clearinghouse at 1-800-358-9295 or by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
7. Highlights From Our Monthly Newsletter
Among the key articles in the August issue of Research Activities are:
- Physicians are more likely to intensify therapy for diabetes when they get unfavorable blood-sugar test results during visits.
Controlling blood-sugar levels can delay or prevent complications of both insulin-dependent (type-1) and noninsulin-dependent (type 2) diabetes. Providers often fail to intensify diabetes therapy appropriately when patient glycemic control is poor. Making A1c test results available during medical visits may help to counteract this clinical inertia.
Other articles include:
- Nonsmokers and previous smokers have less angina and function better physically than smokers after coronary angioplasty.
- Ongoing distress from a traumatic event, not the trauma itself, is related to impaired functioning in patients with chronic pain.
- Studies examine black-white differences in low birthweight, uterine surgery outcomes, and organ donations.
Select Research Activities to read these articles and others.
8. 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.
Shiffman RN, Shekelle P, Overhage JM, Slutsky J, Grimshaw J, Deshpande AM. Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Ann Int Med 2003 September 16;139(6); 493-8. Select to access the abstract on PubMed®.
White C. Rehabilitation therapy in skilled nursing facilities: effects of Medicare's new prospective payment system. Health Aff 2003 May-June;22(3):214-23. Select to access the abstract on PubMed®.
Wolinsky FD, Wyrwich KW, Kroenke K, et al. 9-11, personal stress, mental health, and sense of control among older adults. J Gerontol Soc Sci 2003 May;58(3):S146-50. Select to access the abstract on PubMed®.
Carter R, Holiday DB, Nwasuruba C, et al. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest 2003 May;123(5):1408-15. Select to access the abstract on PubMed®.
Fitzgibbons RJ, Jonasson O, Gibbs J, et al. The development of a clinical trial to determine if watchful waiting in an acceptable alternative to routine herniorrhaphy for patients with minimal or no hernia symptoms. J Am Coll Surg 2003 May;196-(5):737-42. Select to access the abstract on PubMed®.
Mehta KM, Yaffe K, Langa KM, et al. Additive effects of cognitive function and depressive symptoms on mortality in elderly community-living adults. J Gerontol Med Sci 2003 May;58(5):M461-7. Select to access the abstract on PubMed®.
Peterson-Sweeney K, McMullen A, Yoos L, et al. Parental perceptions of their child's asthma: management and medication use. J Pediatr Health Care 2003 May-Jun;17(3):118-25. Select to access the abstract on PubMed®.
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Current as of September 2003