This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
AHCPR-sponsored guidelines help users increase quality
and cut costs
The Agency for Health Care Policy and Research's experience with
clinical practice guidelines has demonstrated that evidence-based
practice recommendations can be incorporated into guidelines for
a range of providers and programs that yield major improvements
in outcomes and costs. As reported previously (in the April 1996
issue of Research Activities), AHCPR is no longer
involved in developing clinical practice guidelines. The Agency
will focus instead on assisting private-sector groups by
supplying them with the scientific evidence they need to develop
their own guidelines.
The following examples describe how evidence-based guidelines
developed from AHCPR's work are being used.
- Florida's Agency for Health Care Administration developed a
practice guideline for treating low back pain based largely
on AHCPR's guideline. It is expected to save the State
nearly $100 million in a single year of workers'
compensation direct health care costs.
- Kentucky now requires insurers handling workers'
compensation claims for back injury to use the State's new
low back pain practice parameter as the standard for
utilization review. The parameter closely follows AHCPR's
acute low back problems guideline.
- The California Division of Workers' Compensation, Colorado
Department of Labor and Employment, Connecticut Workers'
Compensation Commission, Montana Department of Labor and
Industry, Oklahoma Workers' Compensation Court, Texas
Workers' Compensation Commission, and Utah Industrial
Commission have used or are using AHCPR's acute low back
problems guideline to help develop their own back pain
- The Ohio Department of Human Services endorsed AHCPR's
failure guideline and notified over 20,000 physicians
practicing in the State of the anticipated health care
improvements and cost savings that could result from
following the guideline.
- Maryland designated AHCPR's urinary incontinence guideline
as a standard to be followed by public and private health
care organizations within the State.
- California requires that all physicians practicing in the
State be made aware of AHCPR's acute pain management
- Texas' long-term care facility surveyors use AHCPR's
pressure ulcer prevention and urinary incontinence
guidelines to help identify and correct problems in the
State's 2,378 nursing homes, personal care homes, and
facilities for the mentally retarded.
A growing number of employers are using AHCPR guidelines and
consumer guides, including Bristol-Myers Squibb. At the company's
New Brunswick, NJ, facility, AHCPR's acute low back problems
guideline is helping physicians treat employees' low back
problems successfully for one-fifth of the national average cost.
Examples from other corporate users include:
- Employees of Consolidated Edison Company of New York, Inc.,
who were treated for acute low back pain according to
recommendations in AHCPR's guideline returned to work about
2 weeks sooner than workers treated by more traditional
- Hewlett-Packard developed a company protocol for handling
employees' back problems that closely parallels the
recommendations in AHCPR's guideline.
Insurers also are using AHCPR's acute low back problems
guideline. For example, the guideline has helped Houston,
TX-based WorkCare, Inc., to curb medically unnecessary MRI scans
and contest other claims that appear unjustified, such as overuse
of prescription medicines.
Zenith Insurance Company, a Woodland Hills, CA-based insurer, has
cut costs for back pain treatment by 65 percent, in part by
creating treatment protocols based on AHCPR's acute low back
problems guideline and sending the protocols to physicians who
treat workers' compensation patients.
Managed care organizations, hospitals, home health agencies, and
nursing homes also use AHCPR's guidelines. For example:
- CAPP CARE, Inc., a 3.8 million-member preferred provider
organization based in Newport Beach, CA, is developing a
prototype software application run on a portable hand-held
device that will allow its 110,000 physicians to quickly
access guidelines developed by AHCPR and others and match
the guidelines' recommendations to patients' diagnoses.
- Gulf Atlantic Management Group, a large Florida-based
preferred provider network, is integrating copies of AHCPR's
acute low back problems guideline into its manual for
current physician providers and newly contracted PPO and HMO
- AHCPR's acute pain management guideline has helped shorten
the hospital stays of surgical patients at Memorial Medical
Center in Modesto, CA, by an average of 3.5 days.
- Use of AHCPR's unstable angina guideline has helped North
Mississippi Medical Center in Jackson reduce test costs for
emergency room patients complaining of chest pain.
- Staff at the Heritage Manor Nursing Home in Chattanooga,
used AHCPR's pressure ulcer prevention and urinary
incontinence guidelines to cut the number of incontinent
residents from 52 to 18 and the number of residents with
pressure ulcers from 14 to 5.
AHCPR's quick reference guides for clinicians and consumer guides
are available from AHCPR's clearinghouse. The quick reference
guides, full clinical practice guidelines, and consumer guides
also are available online from AHCPR's Web site. Access these
documents by using a Web browser, specifying URL
http://www.ahrq.gov/clinic/, and clicking on "Clinical Practice
Guidelines Online." A third source is the U.S. Government
Printing Office, which sells individual copies of clinical
practice guidelines and bulk copies of quick reference guides and
consumer guides. For more information, call the GPO order desk at
Return to Contents
Proceed to Next Section