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December 12, 2003, Issue No. 118


AHRQ News and Numbers

In 1999, although prescription medicines accounted for a little less than 16 percent of total health care expenses, they accounted for nearly two-fifths (38 percent) of all out-of-pocket expenses. Medicare beneficiaries paid for a much larger portion of their drug expenses out of pocket (57 percent) than the non-Medicare population (39 percent). [Source: Agency for Healthcare Research and Quality, MEPS Chartbook No. 12: Outpatient Prescription Drug Expenses—1999.]

Today's Headlines:

  1. New AHRQ study finds that minority youths are more likely to be overweight
  2. New AHRQ issue brief and journal articles highlight characteristics of SCHIP enrollees
  3. Study finds benefits to pneumatic otoscopy for diagnosing kids' ear infections
  4. AHRQ articles on managing jaundice in newborns in Pediatrics
  5. Calling all AHRQ researchers! "Help us to help you."
  6. Do you know how AHRQ's research is being used?
  7. New AHRQ clearinghouse transition
  8. New grant reviewers added to AHRQ study sections
  9. AHRQ in the professional literature

1.  New AHRQ Study Finds that Minority Youths Are More Likely To Be Overweight

An AHRQ-funded study indicates that African-American and Hispanic children in the United States 6 to 11 years of age are significantly more likely than non-Hispanic white children of the same age to be overweight, while Asian and Pacific Islander children are slightly less likely to be overweight. Using data from the household health interview component of AHRQ's 1996 Medical Expenditure Panel Survey, the researchers found that 43.9 percent of the African-American children were overweight, as were 37.4 percent of Hispanic children. The researchers also found that 21.1 percent of non-Hispanic white children and 19.6 percent of Asian and Pacific Islander children had excess weight. The study, "Association of Race, Socioeconomic Status and Health Insurance with the Prevalence of Overweight in Children and Adolescents," by AHRQ-funded researcher Jennifer Haas, M.D., was published in the December 1 issue of the American Journal of Public Health.

2.  New AHRQ Issue Brief and Journal Articles Highlight Characteristics of SCHIP Enrollees

The first collection of studies that report on the characteristics of children newly enrolled in the State Children's Health Insurance Program (SCHIP) in multiple states is presented in a new AHRQ issue brief, and five articles and a commentary are presented in a special online supplement to the December issue of Pediatrics. Findings include: most SCHIP enrollees live in working families with incomes equal to or below 150 percent of the federal poverty level, even though families are eligible for the program with incomes as high as 200 percent to 250 percent of the poverty level; a significant proportion of enrollees are black or Hispanic, with racial and ethnic disparities present; and 17 percent to 25 percent of enrollees are children with special health care needs, which is higher than the prevalence in the general population. States included in the studies were Alabama, Florida, Indiana, Kansas, and New York. The studies are products of the Child Health Insurance Research Initiative (CHIRI™), which is a unique collaboration of funders and health services researchers from across the country, including AHRQ, The David and Lucile Packard Foundation, and the Health Resources and Services Administration. Summaries of the articles, links to the articles on the Pediatrics Web site, the issue brief entitled, "Who's Enrolled in SCHIP?" and other findings can be found on the AHRQ Web site.

3.  Study Finds Benefits to Pneumatic Otoscopy for Diagnosing Kids' Ear Infections

Pneumatic otoscopy, a procedure that uses observation of the eardrum and a puff of air to diagnose otitis media with effusion, works at least as well as or better than, as tympanometry, a procedure that uses a low frequency hum and an ear probe. Also, otoscopy may be easier than for pediatricians to use, according to researchers at AHRQ's Southern California Evidence-based Practice Center. Since an eardrum with fluid behind it will not move as freely as a normal eardrum, several techniques for diagnosing fluid involve testing eardrum movement, including pneumatic otoscopy, tympanometry, and acoustic reflectometry. Although not a focus of the study, the researchers, led by Dr. Glenn Takata of the University of Southern California's Children's Hospital in Los Angeles, believe that pneumatic otosocopy might be less costly and more easily used because the otoscope is a standard piece of equipment in most pediatric offices, and the cost of adding an attachment to create the puff of air, called an insufflator, is low (about $8). The study, "Evidence Assessment of the Accuracy of Methods of Diagnosing Middle Ear Effusion in Children with Otitis Media with Effusion," is in the December issue of Pediatrics. Select to access the abstract.

4.  AHRQ Articles on Managing Jaundice in Newborns in Pediatrics

Researchers from AHRQ's Making Advances Against Jaundice in Newborn Care (MAJIC) project published two articles on managing jaundice in newborns in the December issue of Pediatrics. Using a framework developed by the Institute of Medicine, researchers used clinical data, surveys, and literature reviews to suggest improvements that can be made to ensure the first days of life are safe for all newborns. One of the articles, "Applying the 'Ten Simple Rules' of the Institute of Medicine to Management of Hyperbilirubinemia in Newborns," recommends that babies should not be sent home from the hospital until a physician is identified who is willing to take calls and see the baby urgently for jaundice-related problems and also to schedule newborn followup appointments with only 1-2 days notice. In the other article, "Management of Hyperbilirubinemia in Newborns: Measuring Performance Using a Benchmarking Model," researchers suggest that hospitals with access to newborns' inpatient and post-discharge data use their benchmarking model to compare their management of jaundice with a reference population of newborns who received rigorous care. Select to access the abstract of the first article, and select to access the abstract of the second article.

5.  Calling All AHRQ Researchers! "Help Us to Help You."

As you may know, AHRQ can help you promote the findings of your research, but we can't do it without you. AHRQ has been successful in working with our grantees and contractors to promote findings to the media and to transfer knowledge based on the research to appropriate audiences in the health care community. However, we know that we can do better. We need you to notify us when you have an article accepted for publication. Please send a copy of the manuscript, anticipated publication date, and contact information for the journal and your institution's PR office to your AHRQ project officer and to AHRQ Public Affairs at journalpublishing@ahrq.gov. Your manuscript will be reviewed to determine what level of marketing we will pursue. Please be assured that AHRQ always honors the journal embargo. Thank you for your cooperation.

6.  Do You Know How AHRQ's Research Is Being Used?

We are always looking for ways in which AHRQ-funded research, products, and tools have changed people's lives, influenced clinical practice, improved policies, and affected patient outcomes. Impact case studies describe AHRQ research findings in action. These case studies are used in testimony, budget documents, and speeches. We would like to know if you are aware of any impact your AHRQ-funded research has had on health care policy, clinical practice, or patient outcomes. Contact AHRQ's Impact Case Studies Program at (301) 427-1243 with your impact stories.

7.  New AHRQ Clearinghouse Transition

We are currently in the transition stage of moving from our present publications clearinghouse in Columbia, MD, to a new contractor and warehouse in Herndon, VA. During the week of December 15-19, we will be in the process of transferring and reconnecting equipment and telephones at the new facility. Therefore, the clearinghouse will be experiencing down time during that period. Our intent is to have the new facility up and running on December 22. The toll-free phone number for the clearinghouse remains 1-800-358-9295.

8.  New Grant Reviewers Added to AHRQ Study Sections

Some new members have recently been added to AHRQ's Health Services Research Initial Review Group, which comprises five study sections responsible for the peer review of grant applications. On the Health Care Technology and Decision Sciences study section, new members include Mark S. Roberts, M.D., M.P.P., (Chair); Suzanne Bakken, R.N., D.N.Sc.; Daniel F. Heitjan, Ph.D.; Leslie Lenert, M.D.; and Anne Sales, R.N., Ph.D. On the Health Care Quality and Effectiveness Research study section, new members include M. Audrey Burnam, Ph.D.; Martin E. Hickey, M.D.; Charles J. Homer, M.D., M.P.H.; Cynthia Warrick, Ph.D.; and Gary Jeffrey Young, Ph.D., J.D. On the Health Systems Research study section, new members include Stephen S. Mick, Ph.D., (Chair ); Elizabeth H. Bradley, Ph.D., M.B.A.; Carol S. Brewer, Ph.D., R.N.; James M. Gill, M.D., M.P.H.; and Bradford H. Gray, Ph.D. On the Health Research Dissemination and Implementation study section, new members include David Jarjoura, Ph.D.; Jennie R. Joe, Ph.D., M.P.H.; and Marita G. Titler, Ph.D. On the Health Care Research Training study section, new members include Diane P. Martin, Ph.D., (Chair); Timothy D. McBride, Ph.D.; Sharon Muret-Wagstaff, Ph.D.; Francois Sainfort, Ph.D.; Matthew H. Samore, M.D.; and Anthony K. Wutoh, Ph.D., R.Ph. Select to access the Web site for descriptions of these study sections and complete listings of their rosters.

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.

McFarlane JM, Groff JY, O'Brien JA, et al. Behaviors of children who are exposed and not exposed to intimate partner violence: an analysis of 330 black, white, and Hispanic children. Pediatrics 2003 Sep;112(3):e202-7. Select to access the abstract on PubMed®.

Fleishman JA, Hellinger FH. Recent trends in HIV-related inpatient admissions, 1996-2000:a 7-state study. J Acquir Immune Defic Syndr 2003 Sep 1;34(1):102-10. Select to access the abstract on PubMed®.

Ma J, Stafford RS. US physician adherence to standards in asthma pharmacotherapy varies by patient and physician characteristics. J Allergy Clin Immunol 2003 Sep;112(3):633-5. Select to access the abstract on PubMed®.

Zhang J, Johnson TR, Patel VL, et al. Using usability heuristics to evaluate patient safety of medical devices. J Biomed Inform 2003 Feb-Apr;36(1-2):23-30. Select to access the abstract on PubMed®.

Casebeer LL, Strasser SM, Spettell CM, et al. Designing tailored Web-based instruction to improve practicing physicians' preventive practices. J Med Internet Res 2003 Jul-Sep;5(3):e20. Select to access the abstract on PubMed®.

Contact Information

Please address comments and questions regarding the AHRQ Electronic Newsletter to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.

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