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May 28, 2008, Issue No. 258
AHRQ News and Numbers
Lower-income children made almost twice as many visits to hospital emergency departments than higher-income children in 2005. AHRQ's analysis compared rates of emergency room visits by children from low-income communities, where the average household income was $36,999, with those of children from high-income communities with an average household income of over $61,000. The rate for those from low-income communities was 414 visits for every 1,000 children. For children from high-income communities, the rate was 223 visits for every 1,000 children. The study was based on more than 12 million emergency department visits by children under age 18 in 23 states. [Source: Agency for Healthcare Research and Quality, HCUP, Statistical Brief #52: Pediatric Emergency Department Visits in Community Hospitals from Selected States, 2005.]
- AHRQ announces guide to help patients on Coumadin®Warfarin therapy
- New AHRQ-funded study finds gene-based tests need better monitoring
- The "3T's" Road Map to Transform US Health Care commentary published in JAMA
- Task Force recommendation on screening for gestational diabetes available
- AHRQ seeks nominations for members of the U.S. Preventive Services Task Force
- AHRQ podcast features men's health and nurses' guide
- AHRQ's HCUP 2006 Nationwide Inpatient Sample (NIS) now available
- AHRQ's triennial HCUP 2006 Kids' Inpatient Database (KID) will be released in June
- Calling all AHRQ researchers! "Help us to help you."
- AHRQ in the professional literature
1. AHRQ Announces Guide to Help Patients on Coumadin®Warfarin Therapy
AHRQ released a new consumer publication, Your Guide to Coumadin®/Warfarin Therapy. This 20-page, easy-to-read patient brochure, available in English and Spanish, explains what patients should expect and watch out for while undergoing Coumadin®/warfarin therapy. This brochure educates patients about their medication therapy and potentially dangerous side effects, explains how to communicate effectively with their health care providers and provides tips for lifestyle modifications. It also provides information on remembering when to take the medicine, learning how to stay safe while taking the medicine, maintaining a consistent diet and alerting health care providers to concurrent drugs and/or supplements patients are taking to avoid any potential adverse interactions. Select to read our press release and select to access the brochure. A print copy is available by sending an E-mail to email@example.com.
2. New AHRQ-Funded Study finds Gene-Based Tests Need Better Monitoring
A new report on genetic testing calls for the creation of improved public health surveillance databases and health information technologies to monitor the use of gene-based tests and their impact on patient outcomes. Infrastructure to Monitor Utilization and Outcomes of Gene-based Applications: An Assessment found current public health monitoring systems lack the capability to monitor the use or outcomes of gene-based tests and treatments. More than 1,000 gene-based tests are now available to consumers via their clinicians, and many more are expected to become available in the near future. Some of these tests are marketed directly to consumers, though many are only recommended for people with certain risk factors. The Federal Trade Commission has issued a consumer alert on at-home genetic testing and urges consumers to be skeptical of claims made by companies that are marketing these tests directly to consumers. AHRQ recommends patients consult with their clinicians to evaluate their risk factors and determine their need for genetic testing. Select to access the online report.
3. The "3T's" Road Map to Transform US Health Care Commentary Published in JAMA
A recent JAMA commentary examines struggles in the U.S. health system to deliver high-quality care and improved health outcomes due to the systematic failure of discoveries to reach patients in a timely fashion. This commentary written by AHRQ authors, Denise Dougherty, Ph.D., and Patrick H. Conway, M.D., propose a new model, The 3T's Road Map, to transform the U.S. health care system to accelerate the pace at which innovations are implemented in clinical settings by addressing the "how" of health care delivery. This road map is essential to outline the activities, participants, investments, and fundamental shifts required to create and sustain an information-rich and patient-focused health care system that reliably delivers high-quality care. Select to read the abstract in PubMed®.
4. Task Force Updates Recommendation on Gestational Diabetes Mellitus Screening Available
The US Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes mellitus, either before or after 24 weeks' gestation. (I statement) This updates the recommendation on screening for gestational diabetes mellitus issued in 2003. Until there is better evidence, the Task Force suggests that clinicians should discuss screening for gestational diabetes with their patients and make case-by-case decisions. Discussions should include information about the uncertainty of benefits and harms, as well as the frequency of positive screening test results.
Gestational diabetes is a condition characterized by elevated blood sugar that is first recognized during pregnancy. In the United States, it occurs with different frequency in different groups of women-frequency can be anywhere from 1 percent to 9 percent of pregnancies, depending on the group being screened. Women who are older than 25, have had gestational diabetes in a previous pregnancy, or have a family history of diabetes are at higher risk for developing the disorder. African American, Hispanic, American Indian, and Asian women are also at increased risk. Select to access the recommendation statement and supporting documents.
5. AHRQ Seeks Nominations for Members of the U.S. Preventive Services Task Force
AHRQ invites nominations of individuals qualified for open positions to serve as members of the U.S. Preventive Services Task Force. Nominees are sought with expertise in prevention, research methodology, and experience in clinical primary care. Nomination of individuals with specific expertise in family medicine, behavioral medicine, and obstetrics/gynecology are encouraged. Nominations must be submitted by June 20. Select to read the May 21 Federal Register notice for details on submitting nominations.
6. AHRQ Podcast features Men's Health and Nurses' Guide
AHRQ Director Carolyn M. Clancy, M.D., is featured in a recent Healthcare 411 podcast about AHRQ's preventive health care campaign for men, Real Men Wear Gowns. Also featured is a new nurses' guide on patient safety and quality and a News & Numbers about the number of patients stricken by C. difficile, a hospital acquired infection. More than 300 professional organizations, including the American College of Preventive Medicine and the American Association of Colleges of Nursing, shared this podcast with their members. Select to listen to this Healthcare 411 podcast.
7. AHRQ's HCUP 2006 Nationwide Inpatient Sample (NIS) Now Available
AHRQ's Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) featuring 2006 data was recently released. This inpatient care database includes all patients covered by Medicare, Medicaid, private insurance, and the uninsured. The data can be weighted to produce national estimates, allowing researchers and policymakers to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. Select for additional information about the NIS including how to purchase the data. Data from the 2006 NIS can also be also accessed via HCUPnet, the free online data query system.
8. AHRQ's Triennial HCUP 2006 Kids' Inpatient Database (KID) Will Be Released in June
AHRQ's Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) featuring 2006 data will be available by the end of June. The KID is the only dataset on hospital use, outcomes, and charges designed to study children under age 21, regardless of payer--including patients covered by private insurance, Medicaid, and uninsured. The data can be weighted to produce national estimates, allowing researchers and policymakers to use the KID to identify, track, and analyze national trends in pediatric health care issues on utilization, access, charges, quality, and outcomes. Topics include:
Rare conditions, such as congenital anomalies
Common conditions, such as asthma
Economic burden of pediatric conditions, such as adolescent pregnancy
Access to services
Quality of care and patient safety
Impact of health policy changes
Earlier KIDs exist for data years 1997, 2000, and 2003. Select for additional information about the KID including how to purchase the data. Data from the 2006 KID can also be also accessed via HCUPnet, the free online data query system.
9. 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 public relations 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.
10. 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.
Roberts LL, Ely JW, Ward MM. Factors contributing to maternal birth-related trauma. Am J Med Qual 2007 Sep-Oct; 22(5):334-43. Select to access the abstract in PubMed®.
Gonzalez JS, Safren SA, Cagliero E, et al. Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care 2007 Sep; 30(9):2222-7. Select to access the abstract in PubMed®.
Cegala DJ, Street RL jr, Clinch CR. The impact of patient participation on physicians' information provision during a primary care medical interview. Health Commun 2007; 21(2):177-85. Select to access the abstract in PubMed®.
Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care—an interactive sociotechnical analysis. J Am Med Inform Assoc 2007 Sep-Oct; 14(5):542-9. Select to access the abstract in PubMed®.
Kaushal R, Goldmann DA, Keohane CA, et al. Adverse drug events in pediatric outpatients. Ambul Pediatr 2007 Sep-Oct; 7(5):383-9. Select to access the abstract in PubMed®.
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Current as of May 2008