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December 22, 2003, Issue No. 119
AHRQ News and Numbers
In 1999, the average prescription drug expense for people in the community who had some out-of-pocket costs for medications was $547. Medicare beneficiaries comprised only 14 percent of the community population but accounted for more than 41 percent of prescription medicine expenses. The average drug expense for Medicare beneficiaries was $990. [Source: Agency for Healthcare Research and Quality, MEPS Chartbook No. 12: Outpatient Prescription Drug Expenses—1999.]
- AHRQ hosts press briefing on first national reports on health care quality and disparities
- Task Force working group encourages patient-provider partnership in making decisions about preventive care
- Colorectal cancer screening in primary care practice program announcement
- New evidence report summary on total knee replacement available
- Highlights from our most recent monthly newsletter
- AHRQ in the professional literature
1. AHRQ Hosts Press Briefing on First National Reports on Health Care Quality and Disparities
AHRQ Director Carolyn M. Clancy, M.D., hosted a press briefing today to release two new HHS reports that represent the first national comprehensive effort to measure the quality of health care in America and assess differences in access to health care services for priority populations. The congressionally mandated reports, the National Healthcare Quality Report and the National Healthcare Disparities Report, provide baseline views of the quality of health care and differences in use of services. Future reports will help the nation make continuous improvements by tracking quality through a consistent set of measures that will be updated as new measures and data become available. Joining Dr. Clancy at the press event were leading experts from the health care community, including Dick Davidson, American Hospital Association; Yank D. Coble, Jr., M.D., American Medical Association; Lucille C. Norville Perez, M.D., National Medical Association; William A. Alexander, M.D., CIGNA HealthCare; Woodrow Myers, M.D., Wellpoint; and Joxel Garcia, M.D., Pan American Health Organization. Select to access the new AHRQ QualityTools Web site to download the reports online. Launched today, the site serves as a Web-based clearinghouse to make it easier for health care providers, health plans, policymakers, purchasers, patients, and consumers to take effective steps to improve quality. Select to access the HHS press release, which includes a quote from HHS Secretary Tommy G. Thompson. Print copies of the reports also can be obtained by calling 1-800-358-9295 or by E-mailing AHRQPubs@ahrq.hhs.gov.
2. Task Force Working Group Encourages Patient-Provider Partnership in Making Decisions about Preventive Care
Clinicians and patients should work together to make decisions about which preventive services are most appropriate for individual patients, according to a new paper on the need for shared decisionmaking published by a working group of the U.S. Preventive Services Task Force. The working group's paper, "Shared Decisionmaking About Screening and Chemoprevention: A Suggested Approach from the U.S. Preventive Services Task Force," was published in the January issue of the American Journal of Preventive Medicine. Select to access AHRQ's press release and the paper.
3. Colorectal Cancer Screening In Primary Care Practice Program Announcement
AHRQ released a new program announcement to increase the knowledge base for enhanced translation of effective colorectal cancer screening techniques into community practice. Applications are due on February 23 and October 22, 2004; and February 23 and June 23, 2005. Select to access the program announcement.
4. New Evidence Report Summary on Total Knee Replacement Available
For people who suffer from intractable and persistent knee pain and disability, total knee arthroplasty (TKA) is associated with improved function and pain relief, according to a new systematic literature review prepared by AHRQ's Minnesota Evidence-Based Practice Center. Patient outcomes cannot be predicted based on age, sex or obesity; however, patients with rheumatoid arthritis show more improvement than those with osteoarthritis, possibly because their condition is worse before surgery. Two percent of patients undergoing TKA will need a second surgery—called total knee arthroplasty revision or TKAR—within 5 years to repair the original procedure. The report calls for more research to find out how long the functional benefits of TKA will last, when revision surgery might be needed, and how much outcomes vary by patient characteristics and surgical factors, including the number of these procedures performed by the surgeon or the medical center. Select to access the summary of the evidence report on Total Knee Replacement. The EPC report was commissioned for a consensus development conference convened on December 8-10 by the NIH Office of Medical Applications of Research (OMAR) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
5. Highlights From Our Most Recent Monthly Newsletter
Among the key articles in the November issue of Research Activities are:
- Lack of insurance and living in an area with greater managed care activity reduce access to care.
Individuals who do not have health insurance coverage for part of a year or an entire year and those living in areas with more managed care are more likely to have problems accessing care than others. In fact, greater managed care activity is associated with less favorable access to care regardless of insurance status.
Other articles include:
- Computerized ICU information systems can significantly reduce time spent by nurses on documentation.
- Rising health care costs may underlie the decline in employment of people with costly chronic conditions.
- Functional limitations and family stressors worsen psychosocial adjustment among disabled school-aged children.
- Immune activation and related loss of infection-fighting T cells are driven by HIV infection and not illicit drug use.
Select Research Activities to read these articles and others.
6. 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.
Studdert DM, Burns JP, Mello MM, et al. Nature of conflict in the care of pediatric intensive care patients with prolonged stay. Pediatrics 2003 Sep;112(3):553-8. Select to access the abstract on PubMed®.
Selby JV, Scanlon D, Lafata JE, et al. Determining the value of disease management programs. Jt Comm J Qual Saf 2003 Sep;29(9):491-9. Select to access the abstract on PubMed®.
Poon EG, Wang SJ, Gandhi TK, et al. Design and implementation of a comprehensive outpatient results manager. J Biomed Inform 2003 Feb-Apr;36(1-2):80-91. Select to access the abstract on PubMed®.
Swanson KA, Andersen R. Gelberg L. Patient satisfaction for homeless women. J Womens Health 2003 Sep;12(7):675-86. Select to access the abstract on PubMed®.
Jarvik JG. Imaging of adults with low back pain in the primary care setting. Neuroimaging Clin N Am 2003 May;13(2):293-305. Select to access the abstract on PubMed®.
Learman LA, Summitt RL Jr., Varner RE, et al. A randomized comparison of total or supracervical hysterectomy: surgical complications and clinical outcomes. Obstet Gynecol 2003 Sep;102(3):453-62. Select to access the abstract on PubMed®.
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Current as of December 2003