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November 4, 2008, Issue No.266
AHRQ News and Numbers
The rate of patients discharged from hospitals but who still needed home health care increased 53 percent between 1997 and 2006. There was a 30 percent increase in the rate of patients discharged to nursing homes or rehabilitation facilities during the same period. [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Facts and Figures, 2006.]
- More than 2 million children with insured parents are uninsured; most are low or middle income
- National Advisory Council meeting scheduled for November 7
- Task Force recommends interventions to promote and support breastfeeding
- Task Force "I Statement" videos now available
- AHRQ and ODPHP announce redesigned healthfinder.gov
- AHRQ Director Speaks at Electronic Health Record Safety Institute Conference on October 22-23
- Meeting for users of AHRQ CAHPS® and Patient Safety Culture Surveys on December 3-5
- 2009 brings new Adobe-based forms for electronic submission of grant applications
- AHRQ director helps consumers navigate the health care system in a new advice column on the Web
- New evidence report on integrating mental health, substance abuse, and primary medical care is available
- New contractor at EHC's Eisenberg Center
- Highlights from our most recent monthly newsletter
- AHRQ in the professional literature
1. More Than 2 Million Children with Insured Parents Are Uninsured; Most Are Low or Middle Income
Some 2.3 million children, mostly from low- to middle-income families, have no health care coverage to pay for preventive or other medical needs in a given year, even though at least one of their parents is insured, according to a new study supported by AHRQ and NIH's National Center for Research Resources. The study, published in the October 22/29 online issue of JAMA, is one of the first to examine the characteristics of uninsured children under age 19 whose parents were insured all year. These children account for a quarter of the estimated 9 million uninsured children in the United States. Select to read our press release and select to access the abstract in PubMed®.
2. National Advisory Council Meeting Scheduled for November 7
The AHRQ National Advisory Council is scheduled to meet on Friday, November 7, at AHRQ's Eisenberg Conference Center in Rockville, MD. The Council will discuss patient-centered care, quality and value in health care, and updates for AHRQ's National Healthcare Quality Report and National Healthcare Disparities Report.
3. Task Force Recommends Interventions to Promote and Support Breastfeeding
The U.S. Preventive Services Task Force recommends primary care interventions before, around, and after child birth to encourage and support breastfeeding. After evaluating more than twenty-five randomized trials of breastfeeding interventions, the Task Force concluded that coordinated interventions throughout pregnancy, birth, and infancy can increase breastfeeding initiation, duration, and exclusivity. Interventions that include both prenatal and postnatal components may be the most effective at increasing the length of time that infants are breastfed. Breastfeeding has substantial health benefits to babies and their mothers. Babies who are breastfed have fewer infections and allergic skin rashes than formula-fed babies and are less likely to have sudden infant death syndrome. After breastfeeding ends, children who were breastfed are less likely to develop asthma, diabetes, obesity, and childhood leukemia. Women who breastfeed have a lower risk for type 2 diabetes, breast cancer, and ovarian cancer than women who have never breastfed. This is an update to the 2003 recommendation on counseling to promote breastfeeding.
The recommendation appears in the October 21 issue of the Annals of Internal Medicine. The recommendation and materials for clinicians are available on the AHRQ Web site.
4. Task Force "I Statement" Videos Now Available
The U.S. Preventive Services Task Force issues "I statements" when the evidence is insufficient to make a recommendation for or against the provision of a preventive service. In these new videos, the Task Force members talk about "I statements" and how clinicians can apply them in practice. Video topics include: screening for prostate cancer; screening for coronary heart disease with exercise tolerance testing in adults; screening and interventions for overweight children and adolescents; when the evidence is insufficient for adult recommendations; and, when the evidence is insufficient for pediatric recommendations.
5. AHRQ and ODPHP Announce Redesigned healthfinder.gov
An improved and more accessible version of healthfinder.gov has been launched to provide even more news, tips, and tools to help people stay healthy. Information is available in English and Spanish. The site includes these new and easy-to-use features:
- The Quick Guide to Health Living—basic, easy-to-understand information on key prevention topics, including the benefits of taking recommended actions and tips on how to get started.
- Myhealthfinder—personalized health recommendations based on age and sex from the U.S. Preventive Services Task Force, supported by AHRQ.
- Personal Health Tools—menu and activity planners, health calculators, online check-ups, and more.
6. AHRQ Director Speaks at Electronic Health Record Safety Institute Conference on October 22-23
AHRQ and the Electronic Health Record (EHR) Safety Institute at Geisinger Health System sponsored a conference focused on implementing and using EHRs in ways that reliably increase patient safety on October 22-23 in Washington, DC. This conference brought together health care leaders, researchers, and EHR implementers to discuss the factors that lead to the safe and successful use of EHRs as well as the potential for EHRs to contribute to adverse effects across the spectrum of health care. AHRQ Director Carolyn Clancy, M.D., presented opening remarks. "There is substantial evidence that well-implemented EHRs improve the quality of care—in areas including safety," Dr. Clancy said. "This conference is an opportunity to learn how others are using EHRs to increase health care quality and safety, and determine how their experiences can help us refine our efforts."
7. Meeting for Users of AHRQ CAHPS® and Patient Safety Culture Surveys on December 3-5
Register soon to attend AHRQ's joint meeting for users of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) family of surveys and of the AHRQ patient safety culture surveys for hospitals, nursing homes, and medical offices on December 3-5. Registration is free and the meeting will be held at the Doubletree Paradise Valley Resort in Scottsdale, AZ. The main meeting will be December 4-5 and the CAHPS College will be on December 3. The CAHPS® program develops standardized surveys of patients' experiences with health plans, medical groups, hospitals, nursing homes, individual clinicians, and other providers. The program also offers guidance on how to use the survey results to improve quality of care and report useful information to consumers. The patient safety culture surveys are tools that staff in hospitals, nursing homes, and medical offices can use to assess their patient safety culture, track changes in patient safety culture over time, and evaluate the impact of patient safety interventions. AHRQ released the hospital patient safety culture survey in 2004 and plans to issue the surveys for nursing homes and medical offices this fall. Select for more information and to register.
8. 2009 Brings New Adobe®-based Forms for Electronic Submission of Grant Applications
Most electronic grant submissions to AHRQ on or after January 1, must use Adobe® application forms (Go to the NIH Guide Notice at NOT-OD-08-117). As AHRQ/NIH wait to incorporate the latest updates to the Adobe® forms by December, there are two critical points applicants need be aware of:
- New Funding Opportunity Announcements (FOAs) released after September 1, will not have Adobe application forms for downloading until December. At that time, it will be necessary for you to go back to your chosen FOA to download the Adobe®-based application packages. Existing FOAs that were released prior to September 1 will have PureEdge application forms that will remain active and available until they are replaced by Adobe® forms in December. Do not wait for the Adobe® forms to become available—develop your research plan components and required application attachments now!
9. AHRQ Director Helps Consumers Navigate the Health Care System in a New Advice Column on the Web
AHRQ Director Carolyn M. Clancy, M.D., offers advice to consumers in new, brief, easy-to-understand columns. The biweekly columns will help consumers better navigate the health care system. Select to read Dr. Clancy's advice columns.
10. New Evidence Report on Integrating Mental Health, Substance Abuse, and Primary Medical Care Is Available
A new AHRQ evidence report, Integrating Mental Health/Substance Abuse and Primary Care, found evidence that people treated for depression in primary care clinics that provide a coordinated set of services for mental and physical health do better and have fewer symptoms than patients who are treated at sites that just provide health services. However, the researchers could not identify the mechanism by which this improvement occurred; nor could they determine whether any level of traditional beliefs about integrating mental and physical health services, or simply systematic practice, produced the benefit. The authors, led by Mary Butler, Ph.D., did not find sufficient evidence to draw conclusions about the impact of integrating mental health and physical medicine services on patients with anxiety disorders, alcohol use disorders, or other mental or behavioral health problems. AHRQ's University of Minnesota Evidence-based Research Center in Minneapolis conducted the systematic literature review and prepared the report. Select to review the report. A print copy is available by sending an E-mail to firstname.lastname@example.org.
11. New Contractor at EHC's Eisenberg Center
Baylor College of Medicine in Houston has been chosen by AHRQ as the new home for the Effective Health Care (EHC) program's John M. Eisenberg Clinical Decisions and Communications Science Center. Under a two-year, $6.8 million contract, Baylor will translate Effective Health Care research reviews into short, plain-language materials for consumers, clinicians and policymakers. The center will also develop electronic tools for improving physician and patient participation in decision-making about health care. The Effective Health Care progam, authorized by Congress as part of the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, is the federal government's premier sponsor of comparative effectiveness research. Dr. Michael Fordis, founder and director of Baylor's Center for Collaborative and Interactive Technologies, will serve as principal investigator and director of the Eisenberg Center.
12. Highlights from Our Most Recent Monthly Newsletter
The October issue of Research Activities is available online. Key articles included are:
- Patient perceptions of office visit copayments alter care-seeking behaviors.
As health care costs have risen, patient cost-sharing through copayments for office visits and other mechanisms have increasingly been used to reduce unnecessary treatments and costs. A new study found that one out of two patients did not know the amount of their physician visit copayment and 27 percent of patients said they changed their care-seeking behavior because of their perception of the amount of the copayment. Overall, 15 percent reported delaying an office visit and 14 percent avoided car altogether.
Other articles include:
- Women sexually abused by partners have worse health than never abused women, even years after the abuse has stopped.
- Men don't accurately perceive their risk of stroke due to their high blood pressure.
- The impact of drug formularies and other approaches to improve medication use in managed care needs more study.
Select to read these articles and others.
13. 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. .
Wakefield DS, Ward MM, Groath D, et al. Complexity of medication-related verbal orders. Am J Med Qual 2008 Jan-Feb; 23(1):7-17. Select to access the abstract on PubMed®.
Trautmann GM, Kip KE, Richter HE, et al. Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease? Am J Obstet Gynecol 2008 Jan; 198(1):30.e1-7. Select to access the abstract on PubMed®.
Carey EC, Covinsky KT, Lui LY, et al. Prediction of mortality in community-living frail elderly people with long-term care needs. J Am Geriatr Soc 2008 Jan; 56(1):149-59. Select to access the abstract on PubMed®.
Sherbourne CD, Edelen MO, Zhou A, et al. How a therapy-based quality improvement intervention for depression affected life events and psychological well-being over time. Med Care 2008 Jan; 46(1):76-84. Select to access the abstract on PubMed®.
Hsieh M, Auble TE, Yealy DM. Validation of the Acute Heart Failure Index. Ann Emerg Med 2008 Jan; 51(1):37-44. Select to access the abstract on PubMed®.
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Current as of November 2008