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August 15, 2005, Issue No. 175
AHRQ News and Numbers
Between 1997 and 2002, total spending for hospital and doctor visits, prescriptions drugs, and other treatments for mental disorders rose by more than $11 billion, adjusted for inflation. The number of people being treated rose by more than 11 million, the biggest jump among the top five most costly medical conditions. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #80: The Five Most Costly Medical Conditions, 1997 and 2002: Estimates for the U.S. Civilian Noninstitutionalized Population. (PDF File, 94 KB; PDF Help).]
- AHRQ issues new data on the uninsured
- Study finds ICU patients at significant risk for adverse events and serious errors
- Articles offer background on New Effective Health Care program
- Task Force recommends against routine screening for peripheral arterial disease
- AHRQ Quality Indicators User Meeting and AHRQ/Florida State Summit on Public Reporting on September 26-28
- Free AHRQ Web cast about CAHPS® surveys for States set for September 14
- Streaming video, audio, and text transcript of AHRQ Web conference on mass casualty care now available online
- Calling all AHRQ researchers! "Help us to help you."
- AHRQ in the professional literature
1. AHRQ Issues New Data on the Uninsured
New data from AHRQ indicate that Hispanics make up 15 percent of the U.S. population and almost 29 percent of the uninsured. More than one in three Hispanics is uninsured, and 25 percent have only public health insurance. In addition, 36 percent of all uninsured children under 18 are Hispanic, according to 2004 data from AHRQ's Medical Expenditure Panel Survey. Select to read our press
release. There are several statistical briefs including:
- The Uninsured in America, 2004: Estimates for the U.S. Civilian Noninstitutionalized Population under Age 65 (PDF File, 230 KB; PDF Help)
- The Uninsured in America, 1996-2004: Estimates for the U.S. Civilian Noninstitutionalized Population
under Age 65 (PDF File, 148 KB; PDF Help), and
- Health Insurance Status of Children in America, 1996-2004: Estimates for the U.S. Civilian Noninstitutionalized Population under Age 18 (PDF File, 121 KB; PDF Help) about the uninsured.
2. Study Finds ICU Patients at Significant Risk for Adverse Events and Serious Errors
A new AHRQ-funded study shows that patients face a significant risk for preventable adverse events and serious medical errors in hospital critical care units. Researchers found that over 20 percent of the patients admitted to two intensive care units at an academic hospital, a medical intensive care unit and a coronary critical care unit experienced an adverse event. Because these patients are among the sickest, they may be more vulnerable to errors in care, and therefore more susceptible to injury. Of the adverse events in the sample, almost half (45 percent) of them were preventable. A significant number of the adverse events involved medications—most commonly, giving patients the wrong dose. Over 90 percent of all incidents occurred during routine care, not on admission or during an emergency intervention. The study, "The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care," was published in the August issue of Critical Care Medicine. Select to read our press release and select to read the abstract on PubMed®.
3. Articles Offer Background on New Effective Health Care Program
Medicare's prescription drug benefit arrives in 2006, and health plans begin to enroll Medicare beneficiaries this fall. At the same time, AHRQ is launching its new Effective Health Care Program to help patients, clinicians, and payers choose the best treatments for their needs. The new AHRQ program was mandated by Section 1013 of the Medicare Modernization Act, but it also builds on years of experience in AHRQ's Evidence-based Practice Centers (EPCs) and outcomes and effectiveness programs. Two recent publications offer background on the EPC experience and a preview of considerations that will be important for the new AHRQ program. In a commentary entitled "Advancing Excellence in Health Care: Getting to Effectiveness" published by the Journal of Investigative Medicine, AHRQ Director Carolyn M. Clancy, M.D., and Center for Outcomes and Evidence Director Jean Slutsky provide an overview of important issues that will have to be considered with the new program. These include especially the need to provide information in clear, ready-to-use formats for multiple audiences. The article points to the need to develop methods for efficiently generating new evidence through "practical clinical trials," and the authors call attention to the potential role for health information technology in both gathering and disseminating effectiveness information. In June, the Annals of Internal Medicine published a supplement reviewing the experiences and lessons learned since the AHRQ-sponsored EPCs were launched in 1997. Articles in the Annals of Internal Medicine supplement discuss advances in review and methodology achieved by the EPCs, as well as challenges in summarizing and presenting information. The commentary is "Advancing Excellence in Health Care: Getting to Effectiveness." The supplement is "Challenges of Summarizing Better Information for Better Health: The Evidence-Based Practice Center Experience." A limited number of copies are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
4. Task Force Recommends Against Routine Screening for Peripheral Arterial Disease
The U.S. Preventive Services Task Force has again recommended against routine screening for peripheral arterial disease. The Task Force made the same recommendation when they last reviewed the evidence in 1996. The Task Force found no evidence that detecting peripheral arterial disease earlier leads to better health outcomes, especially in individuals who may suffer from the disease and don't experience symptoms. Peripheral arterial disease is a problem with the blood flow in the arteries caused by a buildup of fatty deposits. The diseased arteries become narrow or blocked. Arterial blockage or obstruction of blood flow varies from mild, intermittent calf pain to severe, chronic pain that in some cases may result in arterial bypass or amputation. People who are 65 or over, smokers, people who suffer from diabetes, and those with high cholesterol or high blood pressure are at greater risk for peripheral arterial disease. People who suffer from hardening of the arteries, especially in the heart or brain, also are more likely to suffer from peripheral arterial disease, which can be a risk factor for heart attack or stroke. Select to read the recommendation.
5. AHRQ Quality Indicators User Meeting and AHRQ/Florida State Summit on Public Reporting on September 26-28
Register now for the AHRQ Quality Indicators User Meeting to be held at the AHRQ Conference Center, Rockville, MD, September 26-27. The 2-day meeting is intended for both active users of the AHRQ Quality Indicators (QIs) and for those interested in how the QIs might be used in their organizations. The sessions will focus on a variety of topics, including an upcoming pediatric indicator module, applying the QIs to improve population health, using the QIs as a catalyst for quality improvement, implications of ICD-9-CM coding practices, methods for creating aggregate performance indices, and considerations in using the QIs for comparative reporting and pay-for-performance. On September 28, AHRQ will co-host a State Summit on Public Reporting with the Florida Agency for Health Care Administration. This meeting will build on the information presented at the QIs User Meeting and will focus on proposing consensus-based cooperation among States on public reporting of health care quality information.
6. Free AHRQ Web cast About CAHPS® Surveys for States Set for September 14
On September 14, from 1:00 p.m. to 2:30 p.m., EDT, AHRQ will host a live Web cast on "CAHPS® in the States: Collaboration and Innovation to Maximize Public Resources." The Web cast is geared toward representatives of State organizations interested in creative and resourceful ways to implement CAHPS® ambulatory care surveys. Speakers from the States will include KaraAnn Donavan, Epidemiologist & Statistician, Children and Youth with Special Health Care Needs Section, Colorado Department of Public Health & Environment; and Joseph Anarella, Assistant Director, Bureau of Quality Management and Outcomes Research, New York State Department of Health. In addition, Julie Brown, Project Leader for Ambulatory Care CAHPS®, RAND, will discuss the CAHPS® Consortium's efforts to support the needs of State users.
7. Streaming Video, Audio, and Text Transcript of AHRQ Web Conference on Mass Casualty Care Now Available Online
You can now watch and/or listen to the fully-captioned, streamed video and audio from AHRQ's May 17 Web conference entitled Mass Casualty Care: Overlooked Community Resources. The Web conference focused on key issues surrounding the utilization of resources beyond the emergency department—such as nursing homes, former (shuttered or converted) hospitals, and primary care networks and clinics—for providing mass casualty medical care. The Web conference also highlighted HHS' mass casualty care priorities, activities, and initiatives and offered innovative research, tools and models that can be used in developing effective preparedness strategies for using community resources. This Web conference was aimed at State officials and policymakers responsible for making decisions or administering programs related to public health, health care delivery, the training of health professionals, and emergency preparedness; preparedness planners developing strategies for mobilizing community resources in response to a mass casualty event; administrators of long-term care facilities, such as nursing homes, rehabilitation centers, and assisted living facilities; hospital administrators; and primary care practitioners.
8. 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 firstname.lastname@example.org. 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.
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.
Guise JM, Hashima J, Osterweil P. Evidence-based vaginal birth after Caesarean section. Best Pract Res Clin Obstet Gynaecol 2005 Feb;19(1):117-30. Select to access the abstract on PubMed®.
Baldwin DM, Quintela J, Duclos C, et al. Patient preferences for notification of normal laboratory test results: a report from the ASIPS Collaborative. BMC Fam Pract 2005 Mar 8;6(1):11. Select to access the abstract on PubMed®.
Rhee MK, Slocum W, Ziemer DC, et al. Patient adherence improves glycemic control. Diabetes Educ 2005 Mar-Apr;31(2):240-50. Select to access the abstract on PubMed®.
Phillips LS, Langer RD. Postmenopausal hormone therapy: critical reappraisal and a unified hypothesis. Fertil Steril 2005 Mar;83(3):558-66. Select to access the abstract on PubMed®.
Lee GM, Salomon JA, LeBaron CW, et al. Health-state valuations for pertussis: methods for valuing short-term health states. Health Qual Life Outcomes 2005 Mar 21;3(1):e17. Select to access the abstract on PubMed®.
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Current as of August 2005