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October 15, 2004, Issue No. 150
AHRQ News and Numbers
From 1993 to 2002, the number of hospital discharges for hyperlipidemia increased from 941,722 to 3,946,792. [Source: Agency for Healthcare Research and Quality, HCUP, Nationwide Inpatient Sample, 1993-2002, HCUPnet.]
- HHS awards $139 million to drive adoption of health information technology
- Study finds portion control induces greater weight loss than other behaviors
- Prescriptions for antibiotics to prevent anthrax were uncommon following the 2001 anthrax attacks
- Very little of the variation in quality of diabetes care is explained by practice factors
- Public Reporting and Quality-Based Purchasing: The Evidence Base and Practical Tools—register now for October Web conference series
- Obesity: Latest Evidence on Prevention and Treatment—register now for October 29 Web conference
- Call for abstracts issued for 2005 Building Bridges Conference
- New features added to the National Guideline Clearinghouse™
- AHRQ in the professional literature
1. HHS Awards $139 Million to Drive Adoption of Health Information Technology
HHS announced $139 million in grants and contracts to promote the use of health information technology (HIT). Awarded through AHRQ, this multi-year program builds on President Bush's initiative to use HIT to improve the nation's health care system. These awards will provide insight into how best to use health information technologies to improve patient safety by reducing medication errors; increasing the use of shared health information between providers, laboratories, pharmacies and patients; helping to ensure safer patient transitions between health care settings, including hospitals, doctors' offices, and nursing homes; and reducing duplicative and unnecessary testing. Select to read the HHS press release and select to read the fact sheet for more information about each grant.
2. Study Finds Portion Control Induces Greater Weight Loss Than Other Behaviors
A new study led by Summa Health System researcher Everett E. Logue, Ph.D., shows that portion control induces greater weight loss than other behaviors. The study is the first to document that patients who spend a longer time in the action and maintenance stages for portion control or planned exercise are more likely to lose weight. The reverse was also true: Patients who spent less time in the action and maintenance stages for portion control or planned exercise were more likely to gain weight. The study, funded by AHRQ and NIH's National Institute of Diabetes, Digestive and Kidney Diseases, as well as the Summa Health System Foundation, was published in the September issue of Obesity Research. Select to read the abstract.
3. Prescriptions for Antibiotics to Prevent Anthrax Were Uncommon Following the 2001 Anthrax Attacks
Prescriptions for antibiotics that can be taken in advance to prevent against anthrax were uncommon among concerned patients after September 11, 2001, and the 2001 U.S. anthrax attacks. More than 10,000 affected workers and others nationwide were given 3.75 million prophylactic antibiotic pills through official dispensing campaigns between October 2001 and January 2002. However, media reports suggest that even more prescriptions were given out by individual physicians. Despite widespread popular concern about bioterrorism and speculation about increased patient requests and physician prescribing of antibiotics for anthrax prophylaxis, only one in five patients who initiated discussion about anthrax or smallpox with physicians at a large internal medicine practice in the wake of the 2001 terrorist attacks either requested antibiotics or received them, according to the researchers. The AHRQ-funded study led by Nathaniel Hupert, M.D., M.P.H., of the Weill Medical College of Cornell University, New York, N.Y., and colleagues reviewed the electronic medical records of outpatient telephone contacts and clinic visits at a large, primary care practice in New York City from September 11 to December 31, 2001, to identify factors associated with prescribing antibiotics to prevent anthrax. The study was published in the October 11 issue of the Archives of Internal Medicine. Select to read the abstract in PubMed®.
4. Very Little of the Variation in Quality of Diabetes Care Is Explained by Practice Factors
Physician practice management strategies and financial arrangements have very little impact on quality of diabetes care, according to an AHRQ-funded study. The study, led by Nancy L. Keating, M.D., M.P.H., of Harvard Medical School in Boston, suggests that other approaches may be needed for health care organizations to improve the quality of diabetes care. Quality scores were lower among patients whose physicians were required to serve as a gatekeeper (authorize referrals, hospitalizations, and other services), were paid according to fee-for-service arrangements (versus being paid a set salary), and who were dissatisfied as physicians, but the score differences were small. The study, "The influence of physicians' practice management strategies and financial arrangements on quality of care among patients with diabetes," was published in the September 2004 Medical Care. Select to read the abstract in PubMed®.
5. Public Reporting and Quality-Based Purchasing: The Evidence Base and Practical Tools—Register Now for October Web Conference Series
AHRQ is sponsoring two free, interactive Web conferences in October that will help purchasers understand the evidence base for quality-based purchasing and public reporting and facilitate their use of an important tool set available to assist with evaluations of health care quality. The conferences will help purchasers make well-informed decisions about whether and how to pursue quality-based purchasing. The series also will help plans and providers prepare for and participate in quality-based purchasing and public reporting initiatives. The first conference in the series, "Paying for Performance," will be held October 21 from 3:00 p.m. to 4:30 p.m. EDT. It will feature a look at the current evidence base for quality-based purchasing with an emphasis on practical implications for purchasers and providers. The second conference, "Using Quality Indicators for Hospital-Level Public Reporting & Payment," will be held October 27 from 1:00 p.m. to 2:30 p.m. EDT. It will provide guidance on the benefits and limitations of using AHRQ's Quality Indicators for public reporting of quality or to inform purchasing decisions.
6. Obesity: Latest Evidence on Prevention and Treatment—Register Now for October 29 Web Conference
AHRQ is sponsoring a free, interactive Web conference on October 29 focusing on "Obesity: Latest Evidence on Prevention and Treatment," from 2:00 p.m. to 3:30 p.m. EDT. The Web conference follows in the wake of the publication of AHRQ's new evidence report, Pharmacological and Surgical Treatment of Obesity, and the U.S. Preventive Services Task Force's December 2003 recommendations for screening adults to prevent and detect overweight and obesity. Objectives of the Web conference include helping participants better understand coverage issues related to obesity and the process used by CMS to make coverage decisions; differentiate among various approaches for the prevention and treatment of obesity and identify their strengths and limitations; and understand the value of the emerging evidence base for the pharmacological and surgical treatment of obesity and its use in policy development.
7. Call for Abstracts Issued for 2005 Building Bridges Conference
You are invited to submit abstracts for the 2005 Building Bridges Conference—"Applying Evidence-based Solutions to Health Care Priorities"—to be held April 6-8, 2005, in Santa Fe, NM. The deadline for abstract submissions is Friday, November 12. Select for details about the submission process as well as the conference.
8. New Features Added to the National Guideline Clearinghouse™
On October 11, two enhancements were added to the National Guideline Clearinghouse™ Web site. These enhancements are in response to user feedback. One is a "Guidelines in Progress" page that lists the guidelines submitted to NGC, accepted for inclusion, and for which copyright has been obtained. This page will allow users to see if guidelines of interest to them are being abstracted and prepared for inclusion on the NGC site. The page will change as the status of guidelines in the work queue changes from "in progress" to "published" or "withdrawn." The other enhancement is a listing of withdrawn content on the "What's New This Week" page. This list will identify content no longer considered current or no longer supported by the guideline developer.
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.
Suresh G, Horbar JD, Plsek P, et al. Voluntary anonymous reporting of medical errors for neonatal intensive care. Pediatrics 2004 Jun;113(6):1609-18. Select to access the abstract on PubMed®.
Romano PS, Mutter R. The evolving science of quality measurement for hospitals: implications for studies of competition and consolidation. Int J Health Care Finance Econ 2004 Jun;4(2):131-57. Select to access the abstract on PubMed®.
Feurer ID, Moore DE, Speroff T, et al. Refining a health-related quality of life assessment strategy for solid organ transplant patients. Clin Transplant 2004;18 Suppl 12:39-45. Select to access the abstract on PubMed®.
Montalto D, Bruzzese JM, Moskaleva G, Higgins-D'Allesandro A, et al. Quality of life in young urban children: does asthma make a difference? J Asthma 2004 Jun;41(4):497-505. Select to access the abstract on PubMed®.
Taylor SL, Burnam MA, Sherbourne C, et al. The relationship between type of mental health provider and met and unmet mental health needs in a nationally representative sample of HIV-positive patients. J Behav Health Serv Res 2004 Apr-Jun;31(4):149-63. Select to access the abstract on PubMed®.
Maroney CL, Litke A, Fischberg D, et al. Acceptability of severe pain among hospitalized adults. J Palliat Med 2004 Jun;7(3):443-50. Select to access the abstract on PubMed®.
Bradley EH, Herrin J, Mattera JA, et al. Hospital-level performance improvement: beta-blocker use after acute myocardial infarction. Med Care 2004 Jun;42(6):591-9. Select to access the abstract on PubMed®.
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Current as of October 2004