Online Performance Appendix: Crosscutting Activities Related to Quality, Effectiveness, and Efficiency Research (continued)

Budget Estimates for Appropriations Committees, Fiscal Year 2010

This appendix provides more detailed performance information for all HHS measures related to the Agency for Healthcare Research and Quality's budget.

Research Management

Research management activities for the Agency include items such as salaries and benefits, rent, supplies, travel, transportation, communications, printing and other reproduction costs, contractual services, taps and assessments, supplies, equipment, and furniture.

The FY 2009 Estimate level provides $159,514,000 for Crosscutting Activities Related to Quality, Effectiveness, and Efficiency research, the same level of funding as the prior year. There are two changes within this portfolio that provide a net change of $0.

  • HCQO: Crosscutting Activities Related to Quality, Effectiveness, and Efficiency—Investigator-initiated Research Grants (-$2,478,000): The FY 2009 Estimate includes $37,124,000 (77 grants) in total research grants funds for HCQO: Crosscutting Activities Related to Quality, Effectiveness and Efficiency. This level provides a decrease of $2,478,000 in investigator-initiated grants from the FY 2009 level—equivalent to a decrease of approximately 52 small research grants with an average cost of $50,000. Although the level of funding for total grants decreases from the FY 2009 Omnibus level, the FY 2010 President's Budget Request will fund $8,421,000 in new investigator-initiated research grants. In addition, the FY 2010 estimate level will provide for noncompeting research grant commitments for several grants programs, including the CAHPS® and CERTs programs.

    Funding for CAHPS® grants will total $2.9 million in FY 2010. In FY 2010, the CAHPS® program will ensure that data will be more easily available to the user community and the number of consumers who have access to CAHPS® information to make health choices will increase by 46 percent over baseline (see performance table 1.3.23). If AHRQ meets this target for FY 2010, 146 million consumers will have access to CAHPS® information.

    A total of $11.5 million is provided in FY 2010 in continuation grant support for the CERTs program. This program expects decreases in hospitalization for upper GI bleeding due to adverse events of medication or inappropriate treatment of peptic ulcer disease in those between 65 and 85 years of age and decreased number of admissions will continue to generate a per year drop in per capita charges for GI bleeding. The most recent results from FY 2008 did meet the corresponding target. In FY 2008, the target was a 5-percent drop and the actual result was a 5.1-percent drop ($87.10 per capita). The target selected for FY 2009 is a 6-percent drop ($90.75) relative to the original baseline, which is $99.54. The target selected for FY 2010 is a 7-percent drop. In FY 2009 the program will assess the ambitiousness of current targets.

  • Research Contracts and IAAs ($0): The FY 2010 President's Budget Request maintains research contract and IAA support at $57,490,000. This level of support will allow AHRQ to continue core research contracts and IAAs that support Crosscutting Activities Related to Quality, Effectiveness, and Efficiency research.

    Contracts that will continue in FY 2010 include HCUP at a total of $4.1 million. HCUP has set an effectiveness goal that by FY 2010, at least five organizations will use HCUP databases, products or tools to improve health care quality for their constituencies by 5 percent, as defined by AHRQ Quality Indicators. Of those, 3 new organizations use HCUP/QIs to assess potential areas of quality improvement, and at least 2 of them will develop and implement an intervention based on the QIs. Impact will be observed in 1 new organization after the development and implementation of an intervention based on the QIs. By increasing the number of organizations using HCUP and the Quality Indicator tools, we support the overall program goal. HCUP's long-term goal for efficiency is to achieve wider access to effective health care services and reduce health care costs by increasing the number of partners contributing data to the HCUP databases. Expanding to add new States and increasing the number of partners that contribute ambulatory surgery and emergency department data improves national and regional representation. AHRQ added data from Maine for a total of 39 statewide data organizations participating in HCUP. The number of State Ambulatory Surgery Databases (AS) increased by three partners (California, Maine, and Oklahoma) and the number of State Emergency Department Databases (ED) increased by four partners (California, Maine, and New York, and Rhode Island). They were selected based on the diversity—in terms of geographic representation and population ethnicity—they bring to the project, along with data quality performance and their ability to facilitate timely processing of data.

  • Research Management (+$2,478,000): The FY 2010 President's Budget Request level provides $1,872,000 for pay raise costs for AHRQ as a whole. An additional $606,000 is provided in FY 2010 for required research management increases within AHRQ's budget, including rent increases, travel, printing, and data costs. In FY 2010, research management costs for AHRQ total $67,600,000.

Long-Term Objective 1: Reduce antibiotic inappropriate use in children between the ages of 1 and 14.

MeasureFYTargetResult
4.4.1: The number of prescriptions of antibiotics per child aged 1 to 14 in the United States
(Outcome)
20100.50 per child per yearOct 31, 2010
20090.51 per child per yearOct 31, 2009
20080.52 per child per year0.58 per child
(Target Not Met)
20070.53 per child per year0.52 per child
(Target Not Met)
20060.54 per child per year0.60 per child
(Target Not Met)
20050.55 per child per year0.59 per child
(Target Not Met)



 

MeasureData SourceData Validation
4.4.1MEPSThe MEPS family of surveys includes a Medical Provider Survey and a Pharmacy Verification Survey to allow data validation studies in addition to serving as the primary source of medical expenditure data for the survey. The MEPS survey meets OMB standards for adequate response rates, and timely release of public use data files.

Long-Term Objective 2: Reduce congestive heart failure hospital readmission rates in those between 65 and 85 years of age.

MeasureFYTargetResult
4.4.2: The percentage of hospital readmissions within 6 months for congestive heart failure in patients between 65 and 85 years of age (Outcome)201034%Oct 31, 2010
200934.5%Oct 31, 2009
200835%31.91%
(Target Met)
200735.5%36.51%
(Target Not Met)
200636%36.74%
(Target Not Met)
200537%36.99%
(Target Met)


 

MeasureData SourceData Validation
4.4.2HCUPHCUP and QI Project Officers use established methodology to check data.

Long-Term Objective 3: Reduce hospitalization for upper GI bleeding in those between 65 and 85 year of age.

MeasureFYTargetResult
4.4.3: The decrease in the rate of hospitalization for upper GI bleeding due to the adverse effects of medication or inappropriate treatment of peptic ulcer disease in patients between 65 and 85 years of age. (Outcome)2010-4%Oct 31, 2010
2009-3%Oct 31, 2009
2008-1.8%49.75/10,000 (-3.5%)
(Target Exceeded)
2007-2%51.56/10,000 (-5.2%)
(Target Exceeded)
2006-2%54.38/10,000 (-1.1%)
(Target Not Met)
2005-2%55/10,000 (0%)
(Target Not Met)
4.4.4: The cost per capita of hospital admissions for upper GI bleeding among patients aged 65 to 84. (Efficiency)2010$89.78 per capitaOct 31, 2010
2009$90.75 per capitaOct 31, 2009
2008$91.71 per capita$87.10 per capita
(Target Met)
2007$92.68 per capita$91.81 per capita
(Target Met)
2006$93.64 per capita$93.36 per capita
(Target Met)
2005$94.61 per capita$93.20 per capita
(Target Met)


 

MeasureData SourceData Validation
4.4.3
4.4.4
HCUPHCUP and QI Project Officers use established methodology to check data.

 

Long-Term Objective 4: Achieve wider access to effective health care services and reduce health care costs.

MeasureFYTargetResult
1.3.15: Cumulative number of partners contributing data to HCUP databases will exceed by 5% the FY 2000 baseline of 393
(Output)
2010Increase # of partners providing dataOct 31, 2010
2009Increase # of partners providing data by 3Oct 31, 2009
2008Increase # of partners contributing to HCUP databases

27 AS

25 ED
(Target Met)

2007Increase # of partners contributing to HCUP databases

24 AS

22 ED
(Target Met)

2006N/A21 Ambulatory Surgery (AS)
17 Emergency Department (ED)
(Target Met)
2005N/A5 new outpatient datasets
(Target Met)
1.3.22: Number of additional organizations per year that use Healthcare Cost and Utilization Project (HCUP) databases, products, or tools in health care quality improvement efforts.
(Outcome)
20103 organizationsOct 31, 2010
20093 organizationsOct 31, 2009
20083 organizations5 new organizations-
Kentucky Hospital Association;
SSM Health Care;IN CHCS;
Robert Wood Johnson;
University Hospital
(Target Met)
20073 organizations3 new organizations –
CO Health Institute;
OH Department of Health;
Harvard Vanguard Medical Association & Atrias Health
(Target Met)
20063 organizations3 new organizations-
Organization for Economic Cooperation & Development;
CT Office of Health Care Access;
Dallas-Fort Worth Hospital Council
(Target Met)
20052 organizations2 organizations
(Target Met)


 

MeasureData SourceData Validation
1.3.15HCUP databaseHCUP Project Officer monitors the number of partners and reports by identifying the new data added to the existing baseline.
1.3.22HCUP databaseHCUP and QI Project Officers work with Project Contractors to monitor the field and collect specific information to validate the organizations' use and outcomes.

Long-Term Objective 5: Assure that providers and consumers/patients use beneficial and timely health care information to make informed decisions/choices.

MeasureFYTargetResult
1.3.23: The number of consumers who have access to customer satisfaction data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to make health care choices (Outcome)2010Increase 46% over baseline
(146 million)
Oct 31, 2010
2009Increase 44% over baseline
(144 million)
Oct 31, 2009
2008Increase 42%over baseline
(142 million)
41%
(141 Million)
(Target Not Met)
2007Increase 40% over baseline
(140 million)
41%
(141 Million)
(Target Met)
2006Increase baseline138 Million
(Target Met)
2005Increase baseline135 Million
(Target Met)


 

MeasureData SourceData Validation
1.3.23CAHPS® database National CAHPS® Benchmarking DatabasePrior to placing survey and related reporting products in the public domain, a rigorous development, testing, and vetting process with stakeholders is followed. Survey results are analyzed to assess internal consistency, construct validity, and power to discriminate among measured providers.

3 This measure is annual and represents additional partner data per year. The Healthcare Cost and Utilization Project (HCUP) is a family of health care databases and related software tools and products developed through a Federal-State-industry partnership and sponsored by AHRQ. HCUP databases bring together the data collection efforts of 39 State data organizations, hospital associations, private data organizations, and the Federal Government in a voluntary data sharing partnership to create a national information resource of patient-level health care data. HCUP executes memorandums of agreements with its state-level data partners which specify the partnering arrangements and data permissions and restrictions. At present, only HCUP has held discussions with all the remaining U.S. States that collect and release hospital data to pursue partnership. Four States do not collect hospital inpatient data.

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Current as of May 2009
Internet Citation: Online Performance Appendix: Crosscutting Activities Related to Quality, Effectiveness, and Efficiency Research (continued): Budget Estimates for Appropriations Committees, Fiscal Year 2010. May 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/mission/budget/2010/opa11.html