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August 20, 2004, Issue No. 145

AHRQ News and Numbers

Between 1998 and 2000, approximately 15 percent of residents in rural areas and 13 percent of residents in metropolitan areas in the United States were uninsured. However, nearly three-fourths of uninsured rural residents had a usual source of care (71 percent), compared with just over half (52 percent) of uninsured urban residents. [Source: Agency for Healthcare Research and Quality, MEPS Chartbook No. 13: Health Care in Urban and Rural Areas, Combined Years 1998-2000.]

Today's Headlines:

  1. AHRQ seeks volunteer sites to test Ambulatory CAHPS® (ACAHPS®)
  2. AHRQ study raises concerns about inappropriate medication prescribing for elderly patients
  3. Study finds that women get fewer HIV drugs even when they are privately insured
  4. Third Annual Patient Safety Research Conference set for September 26-28
  5. AHRQ Web audioconference on surge capacity rescheduled for October 26
  6. New feature and more tools added to AHRQ's QualityTools Web site
  7. New features added to the National Guideline Clearinghouse™
  8. AHRQ in the professional literature

1.  AHRQ Seeks Volunteer Sites to Test Ambulatory CAHPS®(ACAHPS®)

AHRQ is seeking volunteer sites for the testing of a draft Ambulatory CAHPS® (ACAHPS®) instrument. This instrument will be part of a suite of standardized patient surveys that are reliable, valid, and provide a flexible, modular approach to measurement. AHRQ has initiated the redesign of the CAHPS® instrument to include different levels of ambulatory health care delivery (i.e., services provided by individual primary care clinicians, sites of care or group practices, and health plans). These levels are not necessarily relevant to all survey users. The modular approach to the ACAHPS® instrument allows users to assess the quality of ambulatory care in their particular markets while maintaining comparability to the ACAHPS® survey users in other markets. The instrument will be tested beginning in 2004 and continuing into 2005. Submissions for participation to test are due on or before October 18. Select to read the August 18 Federal Register notice.

2.  AHRQ Study Raises Concerns About Inappropriate Medication Prescribing for Elderly Patients

A new AHRQ-funded study shows that more than 20 percent of elderly patients filled prescriptions during 1999 for at least one drug that may be inappropriate for their use. Researchers, supported by AHRQ's Center for Education & Research on Therapeutics at the University of Arizona Health Sciences Center in Tucson, investigated the extent of potentially inappropriate medication prescribing for elderly patients in outpatient settings. Individuals age 65 or older are less than 15 percent of the U.S. population, but they make up nearly one-third of the prescription drug users. The study, "Inappropriate Prescribing for Elderly Americans in a Large Outpatient Population," was published in the August 9 issue of Archives of Internal Medicine. Select to read the abstract on PubMed®.

3.  Study Finds That Women Get Fewer HIV Drugs Even When They Are Privately Insured

A new AHRQ study found that women who have HIV disease are significantly less likely to be prescribed newer, more costly but more effective medications even if they have private health insurance. AHRQ's Fred Hellinger, Ph.D., and William Encinosa, Ph.D., found that only 39 percent of HIV-infected women in the health plans of 24 large employers in 2000 were given antiretroviral drugs, versus 71 percent of male enrollees. Furthermore, among those provided this type of therapy, only 31 percent of women were prescribed a protease inhibitor and/or non-nucleoside reverse transcriptase inhibitor, compared with 63 percent of men. This disparity was also reflected in women's and men's drug expenditures and out-of-pocket costs. The study, "Antiretroviral Therapy and Health Care Utilization: A Study of Privately Insured Men and Women with HIV Disease," was published in the August issue of Health Services Research. Select to read the abstract on PubMed®. A print copy of the full article is available by sending an E-mail to

4.  Third Annual Patient Safety Research Conference Set for September 26-28

AHRQ's "Third Annual Patient Safety Research Conference: Making the Health Care System Safer" will be held September 26-28 at the Crystal Gateway Marriott in Arlington, VA.

5.  AHRQ Web Audioconference on Surge Capacity Rescheduled for October 26

Save the date! The next AHRQ Web audioconference in the 2004 Surge Capacity Series has been rescheduled from September 14 to October 26. The audioconference will focus on surge capacity for mass casualties and run from 2:00 p.m. to 3:30 p.m., EDT. We will provide information on the scheduled speakers and how to register online in an upcoming Electronic Newsletter.

6.  New Feature and More Tools Added to AHRQ's QualityTools Web Site

The QualityTools Web site now provides a link to guideline summaries available through the National Guideline Clearinghouse™ (NGC). Select to view summaries. New AHRQ tools on health care for children, minorities, and workers, along with a tool for bioterrorism preparedness, were recently added to QualityTools—a Web-based clearinghouse that gives health care providers, health plans, policymakers, purchasers, patients, and consumers an accessible mechanism to implement quality improvement recommendations, initiatives, or principles. The tools can be used to improve the delivery and receipt of care, inform health care decisions, and educate individuals regarding their own health care needs. The QualityTools Web site also features the National Healthcare Quality Report and the National Healthcare Disparities Report. Select to subscribe to QualityTools Weekly Update Service, which notifies you via E-mail when new tools become available.

7.  New Features Added to the National Guideline Clearinghouse™

As of August 9, all National Guideline Clearinghouse™ (NGC) syntheses became available in PDF format—a printer-friendly version. NGC syntheses are analyses of guidelines that cover similar topic areas. Key elements of each synthesis include the scope of the guidelines, the interventions and practices considered, the major recommendations along with the corresponding rating schemes for quality of the evidence and strength of the recommendation, the areas of agreement, and the areas of difference. Select to read the guideline syntheses. Links to PubMed® are now available (when applicable) from any citation in NGC summaries. PubMed® hyperlinks provide an explicit connection between the evidence and the guideline recommendations.

8.  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.

Simon GE, Cherkin DC, Sherman, KJ, et al. Mental health visits to complementary and alternative medicine providers. Gen Hosp Psychiatry 2004 May-Jun;26(3):171-7. Select to access the abstract on PubMed®.

Bent S, Shojania KG, Saint S. The use of systematic reviews and meta-analyses in infection control and hospital epidemiology. Am J Infect Control 2004 Jun;32(4):246-54. Select to access the abstract on PubMed®.

Sakowski JA, Phillips KA, Liang SY, et al. Willingness to recommend a health plan: who is dissatisfied and what don't they like? Am J Manag Care 2004 Jun;10(6):393-400. Select to access the abstract on PubMed®.

Saag KG, Olivieri JJ, Pationo F, et al. Measuring quality in arthritis care: the Arthritis Foundation's quality indicator set for analgesics. Arthritis Rheum 2004 Jun 15;51(3):337-49. Select to access the abstract on PubMed®.

Smith VC, Zupancic JA, McCormick MC, et al. Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia. J Pediatr 2004 Jun;144(6):799-803. Select to access the abstract on PubMed®.

Griffin MR, Stein CM, Graham DJ, et al. High frequency of use of rofecoxib at greater than recommended does: cause for concern. Pharmacoepidemiol Drug Saf 2004 Jun;13(6):339-43. Select to access the abstract on PubMed®.

Bernstein E, Carey TS, Garrett JM. The use of muscle relaxant medications in acute low back pain. Spine 2004 Jun 15;29(12):1346-51. Select to access the abstract on PubMed®.

Contact Information

Please address comments and questions regarding the AHRQ Electronic Newsletter to Nancy Comfort at or (301) 427-1866.

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Current as of August 2004


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