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May 17, 2002, Issue No. 57
AHRQ News and Numbers
In 1999, 290,356 U.S. patients were hospitalized for schizophrenia, with an average length of stay of 12.5 days and an average charge of $13,609. Of those patients, 6,072 were under the age of 18, and 19,370 were over the age of 65. [Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample].
- New case study indicates that mental health parity did not raise costs for a large employer who used a managed care arrangement
- Study shows that women with pelvic inflammatory disease treated as outpatients have long-term outcomes comparable to those treated as inpatients
- Research finds asthma status worse for black and Hispanic children in managed Medicaid plans
- Study says that hospital admissions are lower among HIV-infected persons receiving HAART in 1999
- Upcoming Child Health Speaker Series Web conference
- Partnerships for quality RFA announced
- Highlights from the most recent edition of our monthly newsletter
- AHRQ in the professional literature
1. New Case Study Indicates that Mental Health Parity Did Not Raise Costs for A Large Employer Who Used a Managed Care Arrangement
In a new AHRQ-funded study, researchers examined the impact of a State's mental health parity mandate on a large employer group that simultaneously implemented a managed care "carve-out" for its mental health and substance abuse benefits. Carve-outs are services provided within a standard health benefit package but delivered and managed by a separate organization. The researchers compared plan costs, use patterns, and access in the year prior to the changes with the three years following the changes. The article, "The Impacts of Mental Health Parity and Managed Care in One Large Employer Group," by AHRQ researcher Samuel H. Zuvekas, Ph.D., and others was published in the May/June 2002 issue of Health Affairs. Select to access the AHRQ press release.
2. Study Shows that Women With Pelvic Inflammatory Disease Treated as Outpatients Have Long-term Outcomes Comparable to Those Treated as Inpatients
A new AHRQ-funded study shows that women with mild to moderate pelvic inflammatory disease (PID) who are treated as outpatients have recovery and reproductive outcomes similar to those for women treated in hospitals. The PID Evaluation and Clinical Health (PEACH) study was a randomized clinical trial designed to compare the effectiveness of inpatient and outpatient treatment strategies in preserving fertility and preventing PID recurrence, chronic pelvic pain and ectopic pregnancy for women with mild to moderate PID. The article, "Effectiveness of Inpatient and Outpatient Treatment Strategies for Women with Pelvic Inflammatory Disease: Results from the PID Evaluation and Clinical Health (PEACH) Randomized Trial," by Roberta B. Ness, M.D., M.P.H., of the University of Pittsburgh, was published in the May issue of the American Journal of Obstetrics and Gynecology. Select to access the AHRQ press release.
3. Research Finds Asthma Status Worse for Black and Hispanic Children in Managed Medicaid Plans
In an AHRQ-funded study, the American Association of Health Plans Foundation and HRSA's Maternal and Child Health Bureau found that black and Hispanic children in managed Medicaid programs had worse asthma status than white children. Black and Hispanic children were also less likely to use preventive asthma medications than white children. These disparities persisted after adjusting for sociodemographic status and family structure and were found to exist regardless of the health plan they were enrolled in or the type of medical practice site where they received care. The study, "Racial/Ethnic Variation in Asthma Status and Management Practices Among Children in Managed Medicaid," by Tracy A. Lieu, M.D., M.P.H., Harvard Pilgrim Health Care and Harvard Medical School, was published in the May issue of Pediatrics.
4. Study Says that Hospital Admissions Are Lower Among HIV-Infected Persons Receiving HAART in 1999
A new study found that use of highly active antiretroviral therapy (HAART) is associated with a lower rate of hospital admission and a higher outpatient visit rate compared with patients not receiving HAART. It also found that African-American patients with HIV disease received less outpatient care and more hospital care than white patients with HIV. However, the average monthly cost of the increased hospital care for African-American patients more than offset their lower outpatient costs, and the total cost of treating an African-American patient was 46 percent greater than the cost of treating a white patient. The findings of this HIV Research Network study are based on a sample of 5,255 patients from 17 health care organizations that offer HIV primary care services at one or more of their clinics. These 17 organizations are located in nine Eastern, Midwestern, and Western States. The HIV Research Network is funded by AHRQ, SAMHSA, HRSA, and the Office of AIDS Research at NIH. The article was published in the May issue of the Journal of Acquired Immune Deficiency Syndromes.
5. Upcoming Child Health Speaker Series Web Conference
Mark your calendars. AHRQ will be sponsoring a child health speaker series Web conference with two experts on pediatric patient safety issues on July 17 at 2:00 p.m. The presenters will be Drs. Rainu Kaushal from Harvard Medical School and Marlene Miller from AHRQ. For further information, contact Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.
6. Partnerships for Quality RFA Announced
AHRQ issued a Request for Applications (RFA) for cooperative agreements to improve the quality of health care and enhance the health care system's ability to deliver that care. This RFA will support creation or facilitation of partnerships among organizations with the ability to influence health care organization and clinical practice. The partnerships will primarily focus on priority health conditions such as diabetes and heart disease and important issues facing the health care system such as long-term care and bioterrorism. AHRQ expects to fund up to 10 awards for a total of $1 million; an additional $1 million is available for supplemental funding for bioterrorism preparedness activities. Letters of intent are due June 20; applications are due July 17. Select to access the RFA.
7. Highlights from the Most Recent Edition of Our Monthly Newsletter
The new issue of the Research Activities is in the mail. The key articles are:
- Lipid-lowering medication should be considered early in treatment of blacks with diabetes and high LDL cholesterol levels.
- Training, feedback on performance, and clinical reminders may encourage doctors to intensify therapy for patients who need it.
- Certain verbal and nonverbal behaviors by physicians are associated with favorable patient outcomes.
- Employers may be able to lower their costs for health insurance by offering more plans and making employees more price sensitive.
- School-based dental sealant programs can improve the dental health of poor children at minimal cost.
Select to access these articles and others.
8. AHRQ in the Professional Literature
Shatin D, Drinkard CR. Ambulatory use of psychotropics by employer-insured children and adolescents in a national managed care organization. Ambul Pediatr 2002 Mar-Apr; 2(2):111-9. Select to access the abstract on PubMed®.
Teich JM, Wagner MM, Mackenzie CF, et al. The informatics response to disaster, terrorism, and war. J Am Med Inform Assoc 2002 Mar-Apr; 9(2):97-104. Select to access the abstract on PubMed®.
Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Hysterectomy status and life satisfaction in older women. J Womens Health Gend Based Med 2002 Mar-Apr; 11(2):181-90. Select to access the abstract on PubMed®.
Giffin JM, Fuhrer R, Stansfeld SA, et al. The importance of low control at work and home on depression and anxiety: do these effects vary by gender and social class? Soc Sci Med 2002 Mar; 54(5):783-98. Select to access the abstract on PubMed®.
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Current as of May 2002