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AHCPR Awards 10 Large Grants in Areas of Emphasis

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Press Release Date: June 28, 1999

The Agency for Health Care Policy and Research (AHCPR) today announced funding for 10 new research projects which reflect the key goals in the Agency's strategic plan: improving health outcomes; strengthening quality measurement and improvement; and identifying strategies to improve access, foster appropriate use, and reduce unnecessary health care expenditures. AHCPR's strategic plan is available online at AHCPR has awarded a total of $8.98 million over a 3-year period for these projects, and anticipates funding additional grants by the end of Fiscal Year 1999. The newly funded projects are:

AHCPR Strategic Goal No. 1: Support Improvements in Health Outcomes

Optimal Antithrombotic Therapy in Atrial Fibrillation. Principal investigator: Brian F. Gage, MD, Barnes-Jewish Hospital, St. Louis, MO. $377,261; 7/1/99-6/30/02.

This study will address the shortcomings of previous available data on patients with atrial fibrillation and the use of antithrombotic therapy. Underuse of warfarin in elderly patients with nonvalvular atrial fibrillation has been documented repeatedly and appears to result in part from uncertainty about the conflicting benefits and risks of anticoagulation in the very old.

Effects of a Nursing-based Intervention in Two Emergency Departments. Principal investigator: Lorraine C. Mion, BSN, MSN, PHD, The Cleveland Clinic Foundation, Cleveland, OH. $894,143; 6/1/99-5/31/01.

This study proposes to evaluate a recently awarded Robert Wood Johnson Foundation demonstration grant, based in the emergency department and aimed at maintaining frail elderly in the community setting.

Online Commentary Use and Antimicrobial Prescribing. Principal investigator: Rita M. Mangione-Smith, MD, University of California Los Angeles, Los Angeles, CA. $90,030; 7/1/99-9/30/00.

The objective of this study is to gain a better understanding of how physicians use online commentary (the description of physical findings and observations on the part of the physician to the parent as they are being observed) in response to both explicit and perceived parental expectations for antimicrobials in the pediatric outpatient setting.

Preferences for Short-Term Health States in Radiology. Principal investigator: Francois Sainfort, Ph.D., University of Wisconsin, Madison, WI. $519,062; 7/1/99-6/30/01.

This is a study of patient preferences that focuses on vascular disease. This project seeks to estimate the short-term, preference-based, quality of life effects of imaging tests, including conventional angiograms and magnetic resonance angiograms.

Guideline to Improve Quality of Initial Pneumonia Care. Principal investigator: Michael J. Fine, MD, MSc, University of Pittsburgh School of Medicine, Pittsburgh, PA. $4,944,640; 7/1/99-12/31/02.

The objectives of this randomized clinical trial are to reduce appropriately the number of low-risk patients who are hospitalized for the treatment of community-acquired pneumonia (CAP) and to improve the quality of initial medical management for patients with CAP treated in hospital emergency departments.

AHCPR Strategic Goal No. 2: Strengthen Quality Measurement and Improvement

Best Managed Care Practices for Children with Chronic Conditions. Principal investigator: Frederick Connell, MD, MPH, University of Washington, Seattle, WA. $1,071,185; 7/1/99-6/30/02.

This observational study will examine how the structural characteristics, incentives, and quality assurance efforts of managed care organizations in Washington state affect the quality of care for children with chronic conditions such as asthma, diabetes, low birth weight, and cerebral palsy.

Nurse Staffing and Quality of Care. Principal investigator: Peter I. Buerhaus, Ph.D., RN, FAAN, Harvard University, Boston, MA. $691,401;7/1/99-6/30/01.

The purpose of this study is to: (1) test and improve the methods available for measuring hospital-level patient acuity, nurse staffing levels, and adverse nurse-sensitive events (ANSE), (2) analyze the relationship between hospital nurse staffing levels and the quality of patient care, specifically the rate of ANSE over time, and (3) assess the impact of market forces on hospital nurse staffing levels and the rates of ANSE over time.

AHCPR Strategic Goal No. 3: Identify Strategies To Improve Access, Foster Appropriate Use, and Reduce Unnecessary Expenditures

Adult Medicaid Patients' Dental Visits in Emergency Departments. Principal investigator: Leonard A. Cohen, DDS, MPH, University of Maryland, Baltimore, MD. $139,853; 7/1/99-9/30/00.

This project will evaluate adult Maryland Medicaid patients' pattern of use of hospital emergency departments for the treatment of mouth pain and infections. It also will examine the impact of the elimination of adult Medicaid reimbursement to dentists for the treatment of dental emergencies on these patterns.

Fundamental Measurement for Health Services Research. Principal investigator: William P. Fisher, Ph.D., Louisiana State University School of Nursing, New Orleans, LA. $37,883; 7/1/99-12/31/99.

This study uses data from the AHCPR's Medical Expenditure and Panel Survey to evaluate the potential of using trade-off models for measuring health-related variables.

Timing and Predictors of Nursing Home Transfers. Principal investigator: Richard A. Hirth, MA, Ph.D., University of Michigan, Ann Arbor, MI. $216,598; 7/1/99-12/31/00.

This longitudinal study will focus on measuring patient transfers from one nursing home to another and the identification of resident and facility characteristics associated with different types of transfers.

Select to find out more about AHCPR research findings and publications.

For additional information, contact the AHCPR Press Office (301) 427-1364: Salina Prasad: (301) 427-1864 (

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