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October 2, 2006, Issue No. 211
AHRQ News and Numbers
Workers at the nation's largest private-sector firms pay health insurance deductibles that are about half as expensive as those paid by workers at the smallest companies. Employees of companies with 1,000 or more workers paid $859, on average, to meet their deductible for family-plan coverage in 2004, compared with $1,779 paid by workers in firms with fewer than 10 employees. [Source: Agency for Healthcare Research and Quality (AHRQ), MEPS Statistical Brief No. 142: Co-pays, Deductibles, and Coinsurance Percentages for Employer-Sponsored Health Insurance in the Private Sector, by Firm Size Classification, 2004 (PDF File, 94 KB; PDF Help).
- AHRQ Director Participates in Remaking American Medicine™—PBS Series on Health Care
- AHRQ Comparative Effectiveness Review Finds Heart Attack Risks, Pain Relief Similar for Most Osteoarthritis Drugs
- Kaiser and AHRQ Medical Errors Survey Released
- AHRQ Director Gives Keynote Address at Nurse Alliance of SEIU on Quality
- Latest AHRQ Healthcare 411 Audio Newscast Features Stories on Medical Errors
- Latest Issue of AHRQ WebM&M Available Online
- AHRQ Issues Two New Funding Opportunity Announcements
- AHRQ in the Professional Literature
1. AHRQ Director Participates in Remaking American Medicine™—PBS Series on Health Care
On September 27, AHRQ Director Carolyn M. Clancy, M.D., was a keynote speaker at the national symposium kickoff for Remaking American Medicine™, a Public Broadcasting System (PBS) series on health care that will air this month. PBS will broadcast the four-part series, Remaking American Medicine™—Health Care for the 21st Century, on four consecutive Thursdays at 10 p.m. beginning October 5. Dr. Clancy is interviewed in the episode that will air October 26. Select to access Dr. Clancy's speech and to view the Webcast of the symposium.
2. AHRQ Comparative Effectiveness Review Finds Heart Attack Risks, Pain Relief Similar for Most Osteoarthritis Drugs
AHRQ released a new report that represents the most comprehensive analysis thus far of arthritis pain medications. Two classes of drugs commonly used to treat osteoarthritis—non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors (a newer generation of NSAIDs)—present similar, increased risks of heart attacks while offering about the same level of pain relief. The exception is the drug naproxen, commonly sold as Aleve or Naprosyn, a medication that scientific evidence suggests presents a lower risk of heart attack for some patients than other NSAIDs or COX-2 inhibitors.
The new report, Comparative Effectiveness and Safety of Analgesics for Osteoarthritis, is the newest in a series of Comparative Effectiveness Reviews prepared by AHRQ's Evidence-based Practice Center at Oregon Health & Science University. Select to access our press release and to access the report. (PDF File, 580 KB; PDF Help).
3. Kaiser and AHRQ Medical Errors Survey Released
The Kaiser Family Foundation and AHRQ on September 27 released an updated survey capturing the public's views and knowledge of medical errors and their experiences in taking steps aimed at improving the quality of their care. Since the Institute of Medicine (IOM) issued its landmark study 7 years ago on medical errors in hospitals, there have been a wide range of efforts by hospitals, doctors, health plans, and purchasers to improve the quality and coordination of health care. The new survey updates key questions about these issues that had been asked in 2000, 2002, and 2004 surveys. Findings include:
- About one-in-three people (36 percent) say they have seen information comparing the quality of care provided by health plans, hospitals, and doctors. About one-in-five (20 percent) say they have seen and used such data to make decisions about their care. Both numbers are statistically unchanged from 2004.
- More than half of Americans (55 percent) say they understand the term "medical error," up from 43 percent in 2004 and 31 percent in 2002. After being given a common definition of medical errors, more than four-in-10 (43 percent) say preventable medical errors occur "very often" or "somewhat often" when people seek care from a health professional.
- One-in-three Americans (34 percent) say they have, or a family member has, created a set of their medical records to ensure that their health care providers have all their medical information.
- Substantial numbers of Americans report taking certain actions aimed at improving the coordination of care and reducing the likelihood of a medical error. These include: checking the medication given by their pharmacist against the doctor's prescription (70 percent); bringing a list of all their medications to a doctor's appointment (54 percent); and bringing a friend or relative to a doctor's appointment to help ask questions (45 percent).
Select to access the survey results.
4. AHRQ Director Gives Keynote Address at Nurse Alliance of SEIU on Quality
AHRQ Director Carolyn M. Clancy, M.D., gave a September 25 keynote address at the Nurse Alliance of the Service Employees International Union (SEIU) Networking Conference on Quality in St. Louis, MO. Dr. Clancy discussed the need for a complete change in culture that will change the way that many facilities do business. "As practitioners on the 'sharp edge' of patient care, you can serve as drivers of this evolution—as indispensable leaders in building a culture of quality for your hospitals, for your patients, and for your future at the forefront of patient care in America," said Dr. Clancy.
The SEIU Nurse Alliance consists of more than 84,000 R.N.s in 23 states working together to raise nursing standards and improve patient care. Select to access Dr. Clancy's remarks.
5. Latest AHRQ Healthcare 411 Audio Newscast Features Stories on Medical Errors.
Both stories in this week's audio newscast are about medical errors. The first reports on a study that examined the likelihood that your physician would report a medical error to you. The second features an interview with AHRQ Director Carolyn M. Clancy, M.D., in which she discusses several AHRQ-funded studies that focused on medical errors caused by fatigued hospital interns. Select to access to the 10-minute audio
The newscast can be heard if your computer has a sound card and speakers and can play MP3 audio files, or you can download it to a portable audio device. In any case, you will be able to listen to the latest audio reports from AHRQ at your convenience—according to your schedule, whenever you have time to listen. Visit the main page of our Healthcare 411 series to access any of AHRQ's newscasts and special reports. Sign up for a free subscription to the series to receive notice of all future AHRQ podcasts.
6. Latest Issue of AHRQ WebM&M Available Online
The September 2006 issue of AHRQ WebM&M is now available. This month, the Perspectives on Safety section examines the remarkable safety transformation at the Nation's Department of Veterans Affairs (VA) health care facilities. It features an interview with the Director of the VA National Center for Patient Safety, James Bagian, M.D., a physician, engineer, and astronaut. Ashish Jha, M.D., M.P.H., a Harvard expert on health policy who has studied the VA, offers his perspective on what lessons other health care systems can learn about patient safety from the VA's experience.
In the first Spotlight Case, a series of incomplete signouts leads to delay in diagnosing an elderly man's post-operative pneumothorax. The author is Arpana Vidyarthi, M.D., of University of California, San Francisco. In the second case, an elderly woman who had a do-not-resuscitate order in place required surgery. The DNR order was suspended during surgery with the understanding that it would be reinstated postoperatively, but this fell through the cracks until an observant nurse noticed the discrepancy several days later. In the third case, a woman admitted for heart and respiratory failure is mistakenly given penicillamine (a chelating agent) rather than penicillin (an antibiotic). The error demonstrates what is becoming increasingly well appreciated—computerized order entry systems can create their own new types of errors.
Commentary authors are Bernard Lo, M.D., of University of California, San Francisco and Elizabeth Flynn, Ph.D., of Auburn University, in Alabama. A Spotlight slide presentation is available for download, as always, and you can receive continuing medical education (CME), continuing education units (CEU), or trainee certification by taking the Spotlight Quiz. All previously published commentaries are available under "Case Archive." Please submit cases to AHRQ WebM&M via the "Submit Case" button.
7. AHRQ Issues Two New Funding Opportunity Announcements
AHRQ has published two Funding Opportunity Announcements (FOAs) for its Centers for Education and Research on Therapeutics (CERTs) program. CERTs is a national initiative to increase awareness of the benefits and risks of new, existing, or combined uses of therapeutics through education and research.
Letters of intent should be submitted by November 10. Opening date for submission of applications is November 14, and all applications must be submitted electronically by 5:00 p.m. EST on December 14. Select to submit application(s) for the Research Centers grant and for the Coordinating Center grant.
8. 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.
Bourbonniere M, Feng Z, Angelelli J, et al. The use of contract licensed nursing staff in U.S. nursing homes. Med Care Res Rev 2006 Feb;63(1):88-109. Select to access the abstract in PubMed®.
Lee GM, Gortmaker SL, McIntosh K, et al. Quality of life for children and adolescents: impact of HIV infection and antiretroviral treatment. Pediatrics 2006 Feb;117(2):273-83. Select to access the abstract in PubMed®.
Westfall JM, Van Vorst RF, McGloin J, et al. Triage and diagnosis of chest pain in rural hospitals: implementation of the ACI-TIPI in the High Plains Research Network. Ann Fam Med 2006 Mar-Apr;4(2):153-8. Select to access the abstract in PubMed®.
Reschovsky JD, Hadley J, London BE. Effect of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients. Health Serv Res 2006 Aug;41(4 Pt 1):1200-20. Select to access the abstract in PubMed®.
Parzen M, Lipsitz SR, Fitzmaurice GM, et al. Pseudo-likelihood methods for longitudinal binary data with non-ignorable missing responses and covariates. Stat Med 2006 Aug 30:25(16):2784-96. Select to access the abstract in PubMed®.
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Current as of October 2006