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June 10, 2004, Issue No. 137
AHRQ News and Numbers
Working people ages 16 and over had lower out-of-pocket dental expenses in 2000 than people who were not employed ($174 for employed people versus $256 for unemployed people). Average out-of-pocket expenses for people with at least one dental visit were highest in the Northeast and lowest in the Midwest, although people in the Midwest, West, and South experienced substantial increases in their average out-of-pocket dental expenses (from $139 to $204 in the Midwest, $194 to $240 in the West, and $202 to $245 in the South) between 1996 and 2000. [Source: Agency for Healthcare Research and Quality, MEPS Research Findings #20: Dental Services: Use, Expenses, and Sources of Payment, 1996-2000.]
- Children frequently experience medical injuries in hospitals
- Call for nominations for new class of Patient Safety Improvement Corps
- Free Webcast on updating CAHPS® ambulatory surveys set for June 24
- Translating Research Into Practice conference scheduled July 12 - 14 in Washington, DC
- Medical errors article in Parade magazine
- New AHRQ evidence report helps hospitals respond to bioterrorism or other public health emergencies
- More research needed on use of NSAIDs for cancer pain relief
- AHRQ study on hospital admissions for HIV disease complications
- AHRQ-NEH conference summary is available
- Fact sheets on closing the quality gap are available
- New features available on NGC and NQMC
- AHRQ in the professional literature
1. Children Frequently Experience Medical Injuries in Hospitals
A new AHRQ-funded study shows that children often experience adverse patient safety events-such as medical injuries or errors-in the course of hospital care, with those in vulnerable populations, including children under 1 year old, at highest risk. The study, "Pediatric Patient Safety in Hospitals: A National Picture in 2000," was led by Marlene R. Miller, M.D., from Johns Hopkins Children's Center. Dr. Miller and her colleagues used AHRQ's recently developed Patient Safety Indicators to focus on children in hospitals. They examined 5.7 million hospital discharge records for children under age 19 from 27 states that were drawn from AHRQ's 2000 HCUP State Inpatient Databases. This is one of the first studies to quantify the impact of patient safety events on children in terms of excess hospital stays and charges, as well as the increased risk of death among children due to medical errors. Another AHRQ-funded study, "Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care," by Gautham Suresh, M.D., of the University of Vermont's Center for Patient Safety in Neonatal Intensive Care, found that when a specialty-based, voluntary, anonymous Internet reporting system for identifying medical errors in neonatal intensive care was implemented, a significant number of medical errors were identified. Both articles appeared in the June issue of Pediatrics. Select to read the press release.
2. Call for Nominations for New Class of Patient Safety Improvement Corps
AHRQ, in partnership with the Department of Veterans Affairs' National Center for Patient Safety, is continuing to support a training program called the Patient Safety Improvement Corps. Its purpose is to train teams of state health officials and their selected private or public hospital partners in analyzing reported medical errors, identifying their root causes, and developing and implementing interventions to improve patient safety. The program is free, and the cost of travel and lodging is reimbursed. The new class is scheduled to begin September 21. E-mail notification of intent to submit is due June 30, and applications for participation in the program must be submitted by July 30. Applications must be submitted by state departments of health or other state organizations dealing with the reporting and analysis of medical errors, although teams may be made up of state staff and their selected hospital partner staff. Select to access more information.
3. Free Webcast on Updating CAHPS® Ambulatory Surveys Set for June 24
AHRQ and the CAHPS® Survey Users Network (SUN) are sponsoring a free Webcast on Thursday, June 24 from 1:00 - 3:00 p.m. ET about a new initiative to develop a suite of CAHPS® surveys that cover all levels of ambulatory care. This Webcast, "Updating CAHPS®: Consumer Surveys for Doctors, Groups, and Health Plans," offers a look inside the development of new CAHPS® surveys that are being designed to meet the needs of health plans, providers, purchasers, and consumers. You'll learn:
- What the CAHPS® ambulatory surveys will be.
- How these surveys will meet your information needs.
- Why the current CAHPS® Health Plan and Group Practice Surveys are being updated.
- How these new or refined instruments will influence future survey projects.
- How the development process works and the role you can play in providing input.
4. Translating Research Into Practice Conference Scheduled July 12-14 in Washington, DC
Mark your calendars for TRIP 2004, "Translating Research Into Practice: Advancing Excellence from Discovery to Delivery." This expanded July 12-14 conference at the new Washington, DC, Convention Center, will examine the state-of-the-art and next horizons in implementing research in clinical practice and health policy. AHRQ Director Carolyn Clancy, M.D., and National Health Information Technology Coordinator David Brailer, M.D., Ph.D., are among the keynote speakers, and sessions will focus on knowledge transfer related to ephedra, colorectal and prostate cancer screening, and tobacco cessation interventions for underserved populations. Health care provider organizations, clinicians, patients, purchasers, researchers, innovators, knowledge transfer experts, and others from across the public and private sectors will share research, insights, collaborations, and initiatives for moving knowledge of efficacy and effectiveness into sustained practice change.
5. Medical Errors Article in Parade Magazine
AHRQ Director Carolyn Clancy, M.D., was featured in an article on avoiding medical errors entitled "How You Can Protect Yourself" that was published in the May 23 issue of Parade magazine.
6. New AHRQ Evidence Report Helps Hospitals Respond to Bioterrorism or Other Public Health Emergencies
As part of its public health and emergency preparedness portfolio, AHRQ has released the new evidence report, Training of Hospital Staff to Respond to a Mass Casualty Incident. Developed by AHRQ's Johns Hopkins University Evidence-based Practice Center in Baltimore, the new report is a followup to a 2002 report entitled Training of Clinicians for Public Health Events Relevant to Bioterrorism Preparedness. It identifies key elements to be used in evaluating hospital disaster drills. The new evidence report provided the science behind another recently released AHRQ tool entitled Evaluation of Hospital Disaster Drills: A Module-Based Approach. Select to access the evidence report and the evaluation modules.
7. More Research Needed on Use of NSAIDs for Cancer Pain Relief
The World Health Organization method for cancer pain relief says that treating pain with medication should begin with non-steroidal anti-inflammatory drugs (NSAIDs) before trying opioids. Although many NSAIDs are available, it is unclear which medication is best for relieving cancer-related pain, and if there are clinical differences between them that justify their cost differences, according to a new AHRQ study. Additionally, it is uncertain which opioid and NSAID combinations are the most beneficial to treat cancer pain or even what may be the additional benefit to cancer patients of combining an NSAID with an opioid. Researchers led by Ewan McNicol, R.Ph., of AHRQ's New England Medical Center Evidence-based Practice Center, encourage more specific research to better answer these questions. The article, "Nonsteroidal Anti-Inflammatory Drugs, Alone or Combined with Opioids, for Cancer Pain: A Systematic Review," was published in the May 15 issue of the Journal of Clinical Oncology. Select to read the abstract.
8. AHRQ Study on Hospital Admissions for HIV Disease Complications>
A new AHRQ eight-state study found that hospital admissions for HIV disease complications between 1996 and 2000 decreased the most in those states where low-income people had the least difficulty obtaining expensive anti-retroviral drugs, and conversely, they declined the least in those states where people tended to have the most difficulty accessing the drugs. For example, in Florida and South Carolina, HIV disease hospital admissions declined only 11 percent and 13 percent, respectively, during the 4-year period, compared with declines of roughly 42 percent in New York, 39 percent in Pennsylvania, and 35 percent in New Jersey—states where poor patients had less trouble obtaining medications. Average hospital lengths of stay also varied, ranging from 10 days in New York in 2000 to 6 days in Colorado. That same year, the cost of an HIV hospital stay in California in 2000 averaged nearly $2,979 less than the cost of a similar stay in New York, while in Colorado the cost averaged nearly $4,000 less than New York. The study by AHRQ's Fred Hellinger, Ph.D., "HIV Patients in the HCUP Database: A Study of Hospital Utilization and Cost," was published in the June 2 issue of Inquiry. A print copy of the article is available by sending an E-mail to email@example.com.
9. AHRQ-NEH Conference Summary Is Available
AHRQ has released a new conference summary report, "Setting a Research Agenda for Health and the Humanities." The National Endowment for the Humanities (NEH) and AHRQ convened a conference to explore how expanded interaction between health services researchers and scholars in the humanities might broaden the horizons of health care in America. This report summarizes the recommendations from the conference. The majority of the participants felt that a collaborative research agenda depends on finding ways to introduce and fund truly interdisciplinary rather than multidisciplinary research. In addition to the group as a whole, the conference had four specific workgroups: end-of-life issues, family caregivers, patient safety, and access to care. Two overarching conference recommendations were to initiate a "big picture" analysis of health care and to empower a national summit conference or continuing task force to identify and examine major issues. A print copy of the report is available by sending an E-mail to firstname.lastname@example.org.
10. Fact Sheets on Closing the Quality Gap Are Available
Three new AHRQ fact sheets on closing the quality gap based on reviews conducted by AHRQ's Evidence-based Practice Center at the University of California, San Francisco/Stanford are now available. The first, Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, explores the challenges of translating research into clinical practice. The second and third fact sheets, Closing the Quality Gap: Diabetes Care Strategies and Closing the Quality Gap: Hypertension Care Strategies focus on improving the treatment of patients with these conditions. Select to read our fact sheets. Print copies are available by sending an E-mail to email@example.com.
11. New Features Available on NGC and NQMC
The National Guideline Clearinghouse™ (NGC) and the National Quality Measures Clearinghouse™ (NQMC) Web site, two AHRQ-sponsored online public resources, are now providing a complete summary of each guideline and measure, respectively, in portable document format (PDF) versions that can be downloaded and viewed on all computers that use Adobe®Acrobat Reader®. These versions may also be downloaded to personal digital assistants (PDAs) that can read PDF files.
12. 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.
Plantinga LC, Fink NE, Sadler JH, et al. Frequency of patient-physician contact and patient outcomes in hemodialysis care. J Am Soc Nephrol 2004 Jan;15(1):210-8. Select to access the abstract on PubMed®.
Lan YT, Chang RK, Laks H. Outcomes of patients with double-inlet left ventricle or tricuspid atresia with transposed great arteries. J Am Coll Cardiol 2004 Jan 7;43(1):113-9. Select to access the abstract on PubMed®.
Zhou XH, Castelluccio P. Adjusting for non-ignorable verification bias in clinical studies for Alzheimer's disease. Stat Med 2004 Jan 30;221-30. Select to access the abstract on PubMed®.
Allen EC, Manuel JC, Legault C, et al. Perception of child vulnerability among mothers of former premature infants. Pediatrics 2004 Feb;113(2):267-73. Select to access the abstract on PubMed®.
Corser WD. Postdischarge outcomes rates influenced by comorbidity and interdisciplinary collaboration. Outcomes Manag 2004 Jan-Mar;8(1):45-51. Select to access the abstract on PubMed®.
Phillips KA, Haas JS, Liang SY, et al. Are gatekeeper requirements associated with cancer screening utilization? Health Serv Res 2004 Feb;39(1):153-78. Select to access the abstract on PubMed®.
Pronovost PJ, Weast B, Bishop K, et al. Senior executive adopt-a-work unit: a model for safety improvement. Jt Comm J Qual Saf 2004 Feb;30(2):59-68. Select to access the abstract on PubMed®.
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Current as of June 2004