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March 27, 2008, Issue No. 253
AHRQ News and Numbers
U.S. hospitals treated 308,200 people for attempted suicide, assault, rape, abuse, and other violence-related trauma in 2005 at a cost of $2.3 billion. Although the U.S. Surgeon General has identified violence reduction as a public health priority, the number of violence-related hospitalizations increased by 24,000 between 2002 and 2005. Significant costs for violence-related admissions are passed on to hospitals and taxpayers. In 2005, roughly 23 percent of hospitalizations involved uninsured patients and 27 percent were for Medicaid enrollees. [Source: Agency for Healthcare Research and Quality (AHRQ), HCUP Statistical Brief #48: Violence-Related Stays in U.S. Hospitals, 2005.]
- AHRQ's 2007 State Snapshots provide broader portraits of State-by-State health care performance
- HHS Secretary appoints new members to AHRQ National Advisory Council
- AHRQ awards $5 million to help integrate clinical decision support technologies into health care delivery
- AHRQ and Ad Council encourage Hispanics to become more involved in their health care
- Low cost communication tactics improve medication adherence after heart attack
- AHRQ helps patients take medications on time
- AHRQ unveils new tool to help reduce unnecessary hospitalizations
- AHRQ audio conference on establishing a Patient Safety Advisory Council set for April 8
- Health IT Survey Compendium is available
- Evidence report on Hydroxyurea Treatment of Sickle Cell Disease is available—corrected version
- New evidence report on Management and Postpartum Follow-Up of Gestational Diabetes Mellitus
- AHRQ in the professional literature
1. AHRQ's 2007 State Snapshots Provide Broader Portraits of State-by-State Health Care Performance
A yearly analysis that helps state health leaders identify areas of health care delivery that need quality improvement now includes important information such as each State's rate of obesity, health insurance coverage, mental illness and the number of specialist doctors. Those and other measures—called "State contextual factors"—are part of the 2007 State Snapshots released today by AHRQ. The updated State Snapshots Web tool also tracks States' progress toward reaching government-set health goals for 2010. Users can get more detailed portraits of each State's performance by exploring the State Snapshots' 149 separate measures of quality. Those measures range from preventing pressure sores to screening for diabetes-related foot problems to giving recommended care to pneumonia patients. Finally, the State Snapshots provide State rankings for 15 "selected measures." These rankings show that no State does well or poorly in all areas. AHRQ's annual State Snapshots is based on data drawn from more than 30 sources, including government surveys, health care facilities, and health care organizations.
Select to read our press release and select to access this year's State Snapshots tool.
2. HHS Secretary Appoints New Members to AHRQ National Advisory Council
Department of Health & Human Services (HHS) Secretary Mike Leavitt appointed seven new members to serve on the National Advisory Council for the Agency for Healthcare Research and Quality:
Robert S. Galvin, M.D., M.B.A., Director, Global Health Care, General Electric, Fairfield, CT
Wishwa N. Kapoor, M.D., M.P.H., Director, Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA
Kathleen N. Lohr, Ph.D., M.A., Distinguished Fellow, Health Services Research, RTI International, Research Triangle Park, NC
Michael K. Raymond, M.D., Chief Medical Officer, Rush North Shore Medical Center, Skokie, IL
David Len Shern, Ph.D., President and CEO, National Mental Health Association, Alexandria, VA
William E. Smith, Pharm.D., M.P.H., Ph.D., Executive Associate Dean, School of Pharmacy, Virginia Commonwealth University, Medical College of Virginia, Richmond, VA
Myrl Weinberg, President, National Health Council, Washington, DC
The first meeting for the new council members will be held Friday, April 4, at AHRQ and will be chaired by J. James Rohack, M.D., Senior Staff Cardiologist and Medical Director, Scott and White Health Plan, Scott and White Clinic, Temple, TX. Select to read our press release.
3. AHRQ Awards $5 Million to Help Integrate Clinical Decision Support Technologies Into Health Care Delivery
AHRQ recently awarded $5 million for two new health information technology (Health IT) contracts that will focus on the development, adoption, implementation, and evaluation of best practices using clinical decision support. The Brigham and Women's Hospital, Boston, and Yale University School of Medicine, New Haven, CT, have been selected to incorporate clinical decision support into widely used Health IT products, demonstrate cross-platform utility, and establish lessons learned for clinical decision support implementation across the health IT vendor community.
Select to read AHRQ's press release and for more information on AHRQ's Health IT program.
4. AHRQ and Ad Council Encourage Hispanics to Become More Involved In Their Health Care
AHRQ joined with The Advertising Council to launch a Spanish-language national public service campaign designed to encourage Hispanics to become more involved in their health care. The campaign urges Hispanics to stay healthy for their loved ones by visiting their doctor for regular screenings. Hispanics are 38 percent less likely than non-Hispanics to have visited the doctor within the past year. The new Spanish-language campaign features everyday mothers and fathers whose children see them as superheroes and encourages Hispanic adults to be more involved in their health care, especially preventive care. Research has shown that people who are more involved in their health care tend to have better health outcomes.
Select to read our press release and select to access the information on the AHRQ Web site.
5. Low Cost Communication Tactics Improve Medication Adherence After Heart Attack
Direct-to-patient communication about the importance of continuing prescription drug treatment after a heart attack is a simple, low-cost way to increase the likelihood of patients adhering to life saving therapies at least four out of every five days. In the year following a heart attack, over half of patients may not continue taking their medications—possibly due to a number of factors including concerns about adverse effects, forgetting to refill prescriptions, and interruptions in routine. Personalized letters and educational materials sent directly to heart attack patients increased this measure of adherence by 17 percent. Experts recommend that patients who have heart attacks take medications such as beta blockers on a regular basis to prevent another heart attack and improve survival.
Heart disease is the number one cause of death in the United States, costing an estimated $76 billion to treat in 2005. This AHRQ-funded study was led by investigators at the Kaiser Permanente Center for Health Research in Portland, Oregon, a part of the HMO Research Network Center for Education and Research in Therapeutics, shows how easily-replicated and inexpensive communications tactics can increase adherence to recommended therapies by educating patients about the importance of continuing drug therapy.
The study, "A Randomized Trial of Direct-to-Patient Communication to Enhance Adherence to Beta-Blocker Therapy Following Myocardial Infarction," was published in the March 10 issue of Archives of Internal Medicine. Select to read the abstract in PubMed®.
6. AHRQ Helps Patients Take Medications on Time
Free, online instructions for creating a pill card using only a personal or lap top computer and printer are now available. A pill card can serve as a visual aid for confirming that patients understand how to take the medicines properly and as a reminder to take medicines. AHRQ's How to Create a Pill Card provides step-by-step instructions for making a pill card. One in four Americans do not take prescription medicines as prescribed. Many people who fail to adhere to medication instructions do so because they do not understand how to take their medicines. Research has shown that using a pill card—which uses pictures and simple phrases to show each medicine, its purpose, how much to take, and when to take it—reduces misunderstandings.
Select to download the instructions.
7. AHRQ Unveils New Tool to Help Reduce Unnecessary Hospitalizations
AHRQ has released a free software program that maps AHRQ's Prevention Quality and Pediatric Quality indicators for a State or county and estimates the expected cost savings that could be achieved by reducing potentially avoidable hospitalizations. The Prevention Quality Indicators are designed to screen hospital data for conditions which require hospitalizations, but could be prevented by receiving quality primary care. The Pediatric Quality Indicators screen for quality of care problems in hospitalized children. The tool was designed to help State and local health officials use hospital inpatient discharge data in order to assess whether there is a problem with potentially preventable hospitalizations and medical errors and identify interventions to resolve the issue. The program can also be useful to employers, employer coalitions, Medicaid programs, health departments, hospitals, health systems, health plans, and researchers interested in improving health care quality in the community.
For more information, go to Preventable Hospitalization Costs.
8. AHRQ Audio Conference on Establishing a Patient Safety Advisory Council Set for April 8
Save the date! Hospital leaders and others who want to learn how to get patients and families to partner with health care providers on community-based patient safety advisory councils should mark their calendars for a free audio conference on April 8 from 2:00 to 3:00 p.m., E.D.T. AHRQ grantee Kathy Leonhardt, M.D., M.P.H., of Aurora Health Care in Wisconsin, will present the latest evidence in "How to Develop a Community-Based Patient Safety Advisory Council." The audio conference will feature highlights from a how-to guide developed through AHRQ's Partnerships in Implementing Patient Safety (PIPS) grants program. The PIPS projects focus on implementing safe practice interventions that can be used by those who wish to adapt and/or adopt interventions to improve patient safety in diverse settings.
Select for conference registration and select to learn more about the PIPS projects.
9. Health IT Survey Compendium Is Available
AHRQ has released a new Health IT Survey Compendium. This new survey compendium contains a set of publicly available surveys to assist organizations in evaluating health IT. The surveys cover a broad range of topics, including user satisfaction, usability, technology use, product functionality and the impact of health IT on safety, quality and efficiency.
Select to access the Health IT Survey Compendium.
10. Evidence Report on Hydroxyurea Treatment of Sickle Cell Disease Is Available—Corrected Version
A new AHRQ evidence report finds that clinicians should be encouraged by the proven effect of hydroxyurea in testing sickle cell anemia in children and adults. Although evidence existed to support the efficacy of hydroxyurea, more research is needed on the use of this drug. Study limitations include lack of long-term efficacy data, scant evidence on the benefits for patients with genotypes other than the hemoglobin S mutation, and insufficient long-term data about the potential toxicities of the drug.
The report, Hydroxyurea Treatment of Sickle Cell Disease, was requested and funded by the NIH's Office of the Medical Applications of Research, for a NIH Consensus Development Conference on the topic on February 25-27. AHRQ's Johns Hopkins University Evidence-based Practice Center conducted the systematic literature review and prepared the report. Select to view the report. A print copy is available by sending an E-mail to firstname.lastname@example.org.
11. New Evidence Report on Management and Postpartum Follow-Up of Gestational Diabetes Mellitus
A new AHRQ evidence report finds there are no substantial differences in maternal or neonatal outcomes associated with the use of glyburide or insulin analogues, as opposed to the use of insulin in women with gestational diabetes. The report also finds that further studies are needed to inform the development of evidence-based guidelines for elective induction or cesarean delivery in women with diabetes.
Select to view an abstract of the report. A print copy is available by sending an E-mail to email@example.com.
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.
Setoguchi S, Solomon DH, Glynn RJ, et al. Agreement of diagnosis and its date for hematologic malignancies and solid tumors between Medicare claims and cancer registry data. Cancer Causes Control 2007 Jun; 18(5):561-9. Select to read the abstract in PubMed®.
Tang Z, Weavind L, Mazabob J, et al. Workflow in intensive care unit remote monitoring: a time-and-motion study. Crit Care Med 2007 Sep; 35(9):2057-63. Select to read the abstract in PubMed®.
Bryant Borders AE, Eary RL, Olszewski Y, et al. Ready or not—intrapartum prevention in perinatal HIV transmission in Illinois. Matern Child Health J 2007 Sep; 11(5):485-93. Select to read the abstract in PubMed®.
Forrest CB, Shadmi E, Nutting PA, et al. Specialty referral completion among primary care patients: results from the ASPN Referral Study. Ann Fam Med 2007 Jul-Aug; 5(4):361-7. Select to read the abstract in PubMed®.
Bertakis KD, Azari R. Patient gender and physician practice style. J Women Health 2007 Jul-Aug; 16(6):859-68. Select to read the abstract in PubMed®.
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Current as of March 2008