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June 16, 2008, Issue No.259
AHRQ News and Numbers
Americans spent $11 billion on doctors' bills, prescription drugs, and other medical care to relieve allergy symptoms such as itchy or watery eyes, stuffy noses, wheezing, coughing, and headaches in 2005. The cost is nearly double the $6 billion spent in 2000. [Source: Agency for Healthcare Research and Quality (AHRQ), MEPS Statistical Brief #204: Allergic Rhinitis: Trends in Use and Expenditures, 2000 and 2005.]
- AHRQ director testifies on draft health information technology legislation
- New study shows fast-rising hospital charges for infectious diseases have implications for Medicare
- Evidence-based Hospital Design Web conference set for July 16
- E-prescribing Standards Expert Meeting summary
- New AHRQ Web page highlights tools for hurricane readiness
- New report examines health care efficiency measurement
- AHRQ podcast features Patient Advisory Councils and advice on choosing a health plan
- Task Force updates recommendation on type 2 diabetes
- New evidence report on assisted reproductive technology is available
- Highlights from our most recent monthly newsletter
- AHRQ in the professional literature
1. AHRQ Director Testifies on Draft Health Information Technology (Health IT) Legislation
AHRQ Director Carolyn M. Clancy, M.D., on behalf of the Office of the National Coordinator for Health IT, gave an update on the Department's progress to date and present the Administration's views on draft health information technology legislation before the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health on June 4. Select to read Dr. Clancy's complete testimony.
2. New Study Shows Fast-Rising Hospital Charges for Infectious Diseases Have Implications for Medicare
Hospital charges for treating patients age 65 and older increased by nearly 40 percent between 1998 and 2004—from $31 billion to $46 billion, according to a new study published in the June issue of the Journal of the American Geriatrics Society. During the same period, elderly patients' infectious disease hospitalization rate remained relatively stable at 503 hospitalizations for every 10,000 older adults. Experts are concerned because sustained increases of this magnitude have major implications for Medicare since the elderly population is expected to double by 2030 from 35 million to 72 million and 1 in 5 Americans will be age 65 or older. By 2035, spending by Medicare is projected to increase to 7.5 percent of the U.S. Gross Domestic Product from 2.6 percent in 2004. Select to read the abstract in PubMed®.
3. Evidence-based Hospital Design Web Conference Set for July 16
AHRQ will sponsor a free Web conference, entitled "Transforming Hospitals: Designing for Safety and Quality," on July 16 from 1:30-3:00 p.m. (ET). Hospital executives, clinicians, patient safety advocates, and health care designers are invited to join industry experts to talk about how evidence-based hospital design creates safer and more effective health care facilities. The event will feature the Transforming Hospitals DVD now available from AHRQ. The two-part DVD, which features a 13-minute overview and a 36-minute review of safe design initiatives at three hospitals, makes the case for both new construction and hospital renovation projects and shows how evidence-based hospital design can enhance patient safety, improve quality of care, and increase workforce satisfaction. Select to register. For registration questions, please contact Dana Stelmokas at Hospital_Technical_Assistance@AHRQ.hhs.gov.
4. E-prescribing Standards Expert Meeting Summary
Experts in the field of e-prescribing standards met in February to discuss next steps for three new e-prescribing standards. Experts discussed the technical work needed and additional research and testing required for the RxNorm, Structured and Codified Sig (Sig), and Electronic Prior Authorization (ePA) standards to be recommended for widespread adoption. The standards were not originally ready for the first generation of e-prescribing pilots funded by AHRQ and Centers for Medicare and Medicaid Services in 2005. Select to read the summary of the meeting.
5. New AHRQ Web Page Highlights Tools for Hurricane Readiness
A new Web page to help community and emergency planners prepare for hurricanes and other natural disasters is available on the AHRQ Web site. The tools and resources highlighted can help community and emergency planners: reopen shuttered hospitals to meet casualty demand; use community call centers for crisis support; provide mass medical care with scarce resources; evaluate hospital disaster drills; and locate nursing homes, hospitals, and available resources within communities or nearby States. The material will be available throughout hurricane season, which ends November 30. Select for more information on AHRQ's public health emergency preparedness tools and resources.
6. New Report Examines Health Care Efficiency Measurement
A new AHRQ report shows wide variation in how payers, providers, and others define and evaluate the efficiency that hospitals and physicians use to provide medical care. Since no uniform agreement exists on the definition of efficiency, the results of these analyses depend on the perspective of the evaluator. The report also shows that efficiency measures and methods published in peer-reviewed journals have not been incorporated into measures currently used for public reporting or pay for performance. The report found that efficiency measures, peer-reviewed or elsewhere, have not been validated and evaluated for such uses and that almost none include a quality dimension. The report was based on a research review led by Elizabeth A. McGlynn, Ph.D., at AHRQ's Southern California-RAND Corporation Evidence-Based Practice Center in Santa Monica.
Select to review the report, Identifying, Categorizing, and Evaluating Health Care Efficiency Measures. A print copy is available by sending an E-mail to email@example.com.
7. AHRQ Podcast Features Patient Advisory Councils and Advice on Choosing a Health Plan
This week on Healthcare 411, AHRQ Director Carolyn M. Clancy, M.D., offers consumers advice on how to select a health plan. This podcast also features the toolkit for creating community-based patient advisory councils and a News & Number story about online prescriptions. More than 300 professional organizations, including the Kaiser Family Foundation and America's Health Insurance Plans, shared this podcast with their members. Select to listen to this podcast.
8. Task Force Updates Recommendation on Type 2 Diabetes
The U.S. Preventive Services Task Force recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg. (B recommendation). The Task Force also concludes that current evidence is insufficient to assess the balance of benefits and harms of routine screening for type 2 diabetes in asymptomatic adults with blood pressure of 135/80 mm Hg. or lower. (I statement) The Task Force encourages clinicians to look at a patient's total risk for heart disease in determining whether to screen patients. Screening may be considered on an individual basis if knowing whether a patient has type 2 diabetes helps clinicians decide on strategies to prevent coronary heart disease, including the possible use of lipid-lowering medications or aspirin. This updates the 2003 recommendation. The recommendation and accompanying summary of evidence appear in the June 3 edition of the Annals of Internal Medicine and on the AHRQ Web site.
9. New Evidence Report on Assisted Reproductive Technology Is Available
A new AHRQ evidence report, Effectiveness of Assisted Reproductive Technology, reviews the evidence on the short- and long-term safety and effectiveness of interventions used for assisted reproductive technologies as well as two other types of infertility treatment—ovulation induction and superovulation. Researchers found sufficient evidence to demonstrate improved efficacy (pregnancy and/or live birth) for the following interventions:
- Administration of clomiphene citrate in women with polycystic ovarian syndrome.
- Metformin plus clomiphene in women who fail to respond to clomiphene alone.
- Ultrasound-guided embryo transfer, and transfer on day 5 post-fertilization, in couples with a good prognosis.
- Assisted hatching in couples with previous in vitro fertilization failure.
Select to review an abstract or full version of the report. A print copy is available by sending an E-mail to firstname.lastname@example.org.
10. Highlights From Our Most Recent Monthly Newsletter
The June 2008 issue of Research Activities is available online. Key articles included are:
- Use of dementia treatments is similar in community and long-term care settings.
The prevalence of Alzheimer's disease and related dementias is much larger in long-term care facilities than in the community, but similar proportions of both groups receive antidementia drugs. Select to read this article.
Other articles include:
- Pediatric autopsies shed more light on cause of death in more than half of cases.
- Radiologists vary in how accurately they interpret diagnostic mammograms.
- Diagnosis of bipolar disorder among youth skyrockets.
- Use of quality improvement strategies by home care agencies may reduce hospitalizations of home patients.
Select to read these articles and others.
11. 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.
Norlin C, Sharp AL, Firth SD. Unanswered questions prompted during pediatric primary care visits. Ambul Pediatr 2007 Sep-Oct; 7(5):396-400. Select to read the abstract in PubMed®.
Moreno C, Laje G, Blanco C, Jiang H, et al. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry 2007 Sep; 64(9):1032-9. Select to read the abstract in PubMed®.
Wright RM. Use of osteoporosis medications in older nursing facility residents. J Am Med Dir Assoc 2007 Sep; 8(7):453-7. Select to read the abstract in PubMed®.
Balk EM, Tatsioni A, Lichtenstein AH, et al. Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials. Diabetes Care 2007 Aug; 30(8):2154-63. Select to read the abstract in PubMed®.
Heritage J, Ribinson JD, Elliott MN, et al. Reducing patients' unmet concerns in primary care: the difference one word can make. J Gen Intern Med 2007 Oct; 22(10):1429-33. Select to read the abstract in PubMed®.
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Current as of June 2008