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June 2, 2000, Issue No. 8
AHRQ News and Numbers
- AHRQ's FY 2001 Appropriations
- Direct Access to Specialists May Not Raise Managed Care Plans' Costs
- Study Shows that Hospital Primary Angioplasty Experience is Associated with Higher Survival Rates for Heart Attack Patients
- New England Journal of Medicine (NEJM) Study on CPR
- Medscape Article on Medical Errors
- 20 Tips to Prevent Medical Errors Now Available in Spanish
- Medical Errors Articles
- Second Annual Child Health Services Researchers Meeting
- MEPS Workshop Scheduled for August 7-8, 2000
- The Baxter Allegiance Foundation Prize to Karen Davis
- Kerr White Visiting Scholars Program
- AHRQ in the News
- Guidelines Added to NGC
- New AHRQ Publications
- Ross Arnett's Departure
1. FY 2001 Appropriations Bills Mark Up
On May 24, the House Appropriations Committee passed the FY 2001 appropriations bill for Labor, HHS, and Education programs. This bill includes the House Subcommittee's recommendation of $223,649,000 for AHRQ. Of the $223 million, $20 million is designated for the support of the patient safety initiative. The bill now moves to the House floor.
On May 10, the Senate Appropriations Committee approved $269.9 million with $50 million earmarked for reducing medical errors. This represents an increase of $71.1 million over AHRQ's FY 2000 level.
2. Direct Access to Specialists May Not Raise Managed Care Plans' Costs
According to an AHRQ-funded study, allowing managed care patients direct access to medical specialists may not necessarily increase physician costs for health plans. The study of physician use by enrollees of an open-panel, point-of-service health maintenance organization (HMO) and of a closed-panel gatekeeper HMO found no evidence of higher expenditures for specialists or for physicians services overall in the point-of-service plan. For more information, read "Expenditures for Physician Services under Alternative Models of Managed Care," in the June issue of the Medical Care Research and Review Journal for the full story.
3. Study Shows that Hospital Primary Angioplasty Experience is Associated with Higher Survival Rates for Heart Attack Patients.
Dr. John G. Canto and researchers at the University of Alabama at Birmingham published a study entitled: "The Volume of Primary Angioplasty Procedures and Survival after Acute Myocardial Infarction" in the May 25 issue of the New England Journal of Medicine (NEJM). The AHRQ-funded study examined the records of heart attack patients who were treated at hospitals experienced in performing large numbers of primary angioplasty procedures and determined that they have higher survival rates than patients treated in less experienced facilities. Researchers concluded that the patients treated at these experienced hospitals had a 28 percent lower mortality rate for primary angioplasty (opening blocked arteries by inflating a balloon catheter) than patients treated at the less experienced hospitals. This equals 2 fewer deaths per 100 patients treated. The researchers also studied heart attack patients who received thrombolytic drugs (medications that break up clots to restore blood flow in arteries). In contrast to the primary angioplasty findings, there was no statistical difference in the relationship between hospital experience and patient survival rates.
4. NEJM Study on CPR
An AHRQ-funded study of emergency help for heart attack victims, "Cardiopulmonary Resuscitation by Chest Compression Alone or with Mouth-To-Mouth Ventilation" was published in the May 25 issue of the New England Journal of Medicine. The study found that chest compression alone, when administered by untrained bystanders, is equal to or better than chest compression together with mouth-to-mouth ventilation. In both cases, untrained bystanders received telephone instructions from 911 emergency dispatchers. In addition, chest compression took 1.4 fewer minutes to complete than CPR. Alfred Hallstrom, Ph.D., of the University of Washington was the principal investigator.
5. Medscape Article on Medical Errors
AHRQ Director John Eisenberg is quoted in a recent Medscape article highlighting the debate over medical errors reporting requirements. Select to access the article—which also features comments from Dr. Luciane Leape of the Harvard School of Public Health, Carmela Coyle of the American Hospital Association, Henri Manasse of the National Patient Safety Foundation, Dr. Tejal Gandhi of Brigham and Women's Hospital in Boston, and Steve Meisel, a pharmacist at Southdale Hospital in Edina, MN.
6. 20 Tips to Prevent Medical Errors Now Available in Spanish
AHRQ just released the Spanish language version of our new fact sheet with practical tips to help people protect themselves from errors in their health care. 20 Tips to Prevent Medical Errors has specific, research-based recommendations on preventing medical errors related to medicines, hospital stays and surgery. Select to access either the Spanish language version or the English version.
7. Medical Errors Articles
The June issues of Reader's Digest and Consumer Reports on Health contain articles on medical errors.
8. Second Annual Child Health Services Researchers Meeting
The Second Annual Child Health Services Researchers meeting will be held on Tuesday, June 27 from 12:30-6 p.m. at the Los Angeles Marriott. The meeting is being held in conjunction with the Academy for Health Services Research and Health Policy (AHSRHP, formerly AHSR). The registration fee is $70.
The theme of the Child Health Services Researchers meeting is The Role of Partnerships. The meeting will build on the conceptual frameworks outlined at the successful 1999 meeting; identify gaps in knowledge in child health services research (CHSR) and between knowledge and practice in children's health care; and build partnerships among disciplines, settings, methods, and individuals to build the future of CHSR. Dr. Robert H. Brook, RAND/UCLA, will challenge meeting participants to work actively on these three themes throughout the meeting.
9. MEPS Workshop Scheduled for August 7-8, 2000
AHRQ is offering a 2-day workshop on the Medical Expenditure Panel Survey Household Component. The workshop will be held in the AHRQ Conference Center in Rockville on August 7-8. The workshop will provide practical information about the MEPS survey design, appropriate use of sample weights, file content, and construction of analytic files by data users. Select to access the registration information.
10. The Baxter Allegiance Foundation Prize to Karen Davis
Karen Davis, Ph.D. renowned health economist and President of The Commonwealth Fund, has been named winner of the 2000 Baxter Allegiance Foundation Prize for Health Services Research. Dr. Davis is a member of AHRQ's National Advisory Council. The prize is the highest research honor in the field of health services research. Dr. Davis will be presented this award at the Association of University Programs in Health Administration's annual meeting on June 22-25 in Los Angeles. She is being honored for her contributions to health services research, particularly for her role as a leader in national health policy and her scholarly analysis of access to health care among disadvantaged populations.
11. Kerr White Visiting Scholars Program
AHRQ announced today that it is accepting applications for the newly established Kerr White Visiting Scholars Program. This initiative provides collaborative research opportunities, linking both new and recognized health care research scholars with AHRQ researchers. Visiting scholars will have an opportunity to learn and use AHRQ databases, including the Medical Expenditure Panel Survey (MEPS) and Healthcare Cost and Utilization Project (HCUP). The deadline for applications is September 22.
12. AHRQ in the News
Clancy, CM. Searching for the best of primary care (editorial). J Gen Intern Med 2000 May; 15(5):348-349.
Cohen, SJ. Efficacy, effectiveness, and sustainability: translating research into improvements in health care. Med Care 2000 May; 38(5):449-450. (Cites AHRQ's Translating Research into Practice initiatives and USPSTF guidelines.)
Feldman, R, Christianson, J, and Schultz, J. Selecting health insurance plans. 3. Do consumers use information to choose a health-care provider system? Milbank Q 2000 May, No. 326, 8. (Describes and gives Internet address for expanded HCUPnet.)
Jarlier, A, Charvet-Protat, S. Can improving quality decrease hospital costs? Int J Qual Health Care 2000 April; 125-131. (Cites Eisenberg, et al., Drug inform J, 1988.)
Legnini, MW, Rosenberg, LE, Perry, MJ, et al. Where does performance measurement go from here? Health Aff (Millwood) 2000 May-June; 19(3):173-177.
Morse, SV, Haywood, JL, Goldenberg, RL, et al. Estimation of neonatal outcome and perinatal therapy use. Pediatrics 2000 May; 105(5):1046-1050.
Prager, LO. Physicians urged to make concrete changes on safety. Am Med News 2000 May 15; 43(19):7, 11. (Cites remarks by AHRQ Director John Eisenberg given at AMA-sponsored forum.)
Weingart, SN. Making medication safety a strategic organizational priority. Jt Comm J Qual Improv 2000 June; 26(6):341-348. (Cites AHRQ support of the Executive Session on Medical Error and Patient Safety.)
13. Guidelines Added to National Guideline Clearinghouse™ (NGC)
During the month of May, 21 guidelines were added to the NGC (http://www.guideline.gov). There are now more than 800 guidelines in the NGC. Select to access these guidelines and others.
Coronary artery bypass graft surgery
Chronic pain management in the long-term care setting
Pressure ulcer therapy companion
Cardiac stress test supplement
Deep vein thrombosis
Diagnosis and management of infertility
Management of initial abnormal Pap smear
Routine prenatal care
Management of patients with chronic stable angina
Perimenopausal and postmenopausal hormone replacement therapy
Treatment of patients with delirium
Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices
Combination vaccines for childhood immunization
Venous leg ulcer
Standard for diagnosis and management of invasive breast carcinoma
Prevention of intravascular device-related infections
Prevention of surgical site infection
These are the general activity statistics of the NGC for the period December 15, 1998, through May 13, 2000:
|Number of hits
|Number of requests
|Number of visits
|Average number of requests per visit
|Average visit duration
Hit: any connection to an Internet site, including inline images and errors.
Request: any hit that successfully retrieves content.
Visit: a series of consecutive requests from a user to an Internet site. Includes new + repeat users.
User: anyone who visits the site at least once. Does not include repeat users.
14. Two New AHRQ Publications Have Been Issued
- AHRQ's 2000 Spring/Summer Publications Catalog.
- MEPS Research Findings #11, Health Insurance Status of the Civilian Noninstitutionalized Population: 1998. This report, taken from data from the 1998 Medical Expenditure Panel Survey (MEPS), provides preliminary estimates of the health insurance status of the civilian noninstitutionalized U.S. population during the first half of 1998, including the size and characteristics of the population with private health insurance, with public insurance, and without any health care coverage.
15. Ross Arnett's Departure
On May 3, Ross Arnett resigned as the director of AHRQ's Center for Cost and Financing Studies. Steven Cohen has been named as acting director.
Patients in hospital intensive care units (ICUs) had 80 percent more adverse drug events than patients in general medical wards, and most of the difference was accounted for by the greater number of medications given to the ICU patients. [Original citation: Bates, D.W., and others, "Incidence of Adverse Drug Events and Potential Adverse Events: Implications for Prevention," Journal of the American Medical Association, Vol. 10 (1995b), pp. 199-205.]
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Current as of June 2000