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December 22, 2008, Issue #268
AHRQ News and Numbers
Treating heart attack victims, opening clogged arteries, and treating other common cardiovascular conditions cost U.S. hospitals $57.9 billion in 2006—about 40 percent more than in 1997. Most of this growth in costs, however, occurred between 1997 and 2003. Since 2003, annual growth in costs for these conditions has slowed to less than 2 percent—attributable to a slight decline in the number of heart disease cases and slower increases in the cost per case. [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Facts and Figures, 2006.
- Study Finds Doctors' Use of E-Prescribing Systems Linked to Formulary Data Can Boost Drug Cost Savings
- Nearly All U.S. Hospitals Have Adverse Event Reporting Systems
- Crowding and Staffing Shortages Imperil Safety in Hospital Emergency Departments
- New DEcIDE Studies Evaluate Use of βeta-Blockers
- New Web Resource Aims to Connect Primary Care, Public Health Providers and Patients
- AHRQ in the Professional Literature
1. Study Finds Doctors' Use of E-Prescribing Systems Linked to Formulary Data Can Boost Drug Cost Savings
Electronic prescribing (e-prescribing) systems that allow doctors to select lower cost or generic medications can save $845,000 per 100,000 patients per year and possibly more system-wide, according to findings from a new AHRQ-funded study. The study, entitled "Effect of Electronic Prescribing With Formulary Decision Support on Medication Use and Cost," was published in the December 8 issue of the Archives of Internal Medicine. The finding may have important financial implications, the study authors concluded. As e-prescribing systems become more widely available and easier to use, their greater use among doctors is likely. Complete use of e-prescribing systems with formulary decision support could reduce prescription drug spending by up to $3.9 million per 100,000 patients per year, according to the study's authors. Select to read our press release and select to read the abstract in PubMed®.
2. Nearly All U.S. Hospitals Have Adverse Event Reporting Systems
More than 94 percent of U.S. hospitals have centralized systems for collecting reports of adverse events, but only 21 percent fully distribute and consider adverse event summary reports, according to an AHRQ-funded study, entitled "Adverse-Event-Reporting Practices by U.S. Hospitals: Results of an National Survey." The study, published in the December 8 issue of Quality and Safety in Health Care, was conducted jointly by AHRQ researchers James Battles, Ph.D., and William Munier, M.D., along with researchers from RAND Corporation and The Joint Commission. Hospitals participating in the random, voluntary survey described how their adverse event reporting systems work, the status of reporting practices, and how they use reporting to improve care. Select to read the abstract in PubMed®.
3. Crowding and Staffing Shortages Imperil Safety in Hospital Emergency Departments
Hospital emergency departments are not as safely designed and managed as they should be requiring improvements in working conditions, according to the AHRQ-funded study, "The Safety of Emergency Care Systems: Results of a National Survey of Clinicians in 65 U.S. Emergency Departments," published online in the December 2008 issue of the Annals of Emergency Medicine. The study is the first to closely examine safety from the perspective of emergency department doctors and nurses. Select to read the abstract in PubMed®.
4. New DEcIDE Studies Evaluate Use of βeta-Blockers
Two studies funded by AHRQ's DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) program have added to the knowledge base on the use of βeta-blockers in elderly patients. The studies were published in the December 8/22 issue of the Archives of Internal Medicine. One article, "Comparative Effectiveness of Different βeta-Adrenergic Antagonists on Mortality Among Adults With Heart Failure in Clinical Practice," compared three different βeta-lockers (atenolol, metoprolol tartrate, and carvedilol) in patients with heart failure. The study found that patients who took metoprolol tartrate had a slightly higher risk of death than patients who took atenolol, and that the risk of death was not significantly different between patients who took atenolo or carvedilol. This research was based on 11,326 adults surviving a hospitalization for heart failure and was led by the Harvard Pilgrim Health Care DEcIDE Center at Harvard Medical School. The other article, "Comparative Effectiveness of βeta-blockers in Elderly Patients With Heart Failure," compared the 1-year survival rates of βeta-blockers for which there is evidence (carvedilol, metoprolol succinate, and bisoprolol fumarate) and βeta-blockers that have not been tested in heart failure. The study found similar survival rates but high re hospitalization rates among patients who took the evidence-based βeta-blockers. This research, based on an analysis of 11,959 heart failure patients 65 and older, was led by the Duke University DEcIDE Center.
5. New Web Resource Aims to Connect Primary Care, Public Health Providers and Patients
A new page on the AHRQ Health Care Innovations Exchange Web Site, Linking Clinical Practices and the Community for Health Promotion is designed to help health care professionals find new ways to work together to help patients adopt healthy behaviors and better manage their health. This resource will create new ways to connect patients with services in primary care offices and community settings and increase accessibility to these services. Other features include profiles of innovations that have successfully integrated clinical, public health, and community health services and tools to assist in developing partnerships and referral linkages. The Linking Clinical Practices and the Community for Health Promotion Web page is the newest addition to the Health Care Innovations Exchange, which was launched in 2007, and supports health care professionals in sharing and adopting innovations that improve the delivery of care to patients. For further information or to speak with the developers of this new Web page, please contact Cheryl Thompson by phone at (30l) 427-1271 or by sending an e-mail to Cheryl.Thompson@ahrq.hhs.gov.
6. 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.
Concannon TW, Kent DM, Normand SL, et al. A geospatial analysis of emergency transport and inter-hospital transfer in ST-segment elevation myocardial infarction. Am J Cardiol 2008 Jan 1; 101(1):69-74. Select to access the abstract in PubMed®.
Liang H, Mojtahedi MC, Chen D, et al. Elevated C-reactive protein associated with decreased high-density lipoprotein cholesterol in men with spinal cord injury. Arch Phys Med Rehabil 2008 Jan; 89(1):36-41. Select to access the abstract in PubMed®.
Jasti H, Mortensen EM, Obrosky DS, et al. Causes and risk factors for rehospitalization of patients hospitalized with community-acquired pneumonia. Clin Infect Dis 2008 Feb 15; 46(4):550-6.Select to access the abstract in PubMed®.
Kovac SH, Saag KG, Curtis JR, et al. Association of health-related quality of life with dual use of prescription and over-the-counter nonsteroidal anti-inflammatory drugs. Arthritis Rheum 2008 Feb 15; 59(2):227-33. Select to access the abstract in PubMed®.
Skinner AC, Weinberger M, Mulvaney S, et al. Accuracy of perceptions of overweight and relation to self-care behaviors among adolescents with type 2 diabetes and their parents. Diabetes Care 2008 Feb; 31(2):227-9. Select to access the abstract in PubMed®.
Clabaugh G, Ward MM. Cost-of-illness studies in the United States: a systematic review of methodologies used for direct cost. Value Health 2008 Jan-Feb; 111(1):13-21. Select to access the abstract in PubMed®.
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Current as of December 2008