September 11, 2009
AHRQ News and Numbers
U.S. hospitals spent roughly $56 billion in 2007—16 percent of their overall patient care costs—treating baby boomers ages 55 to 64. With an expected increase of 18 percent by 2020, the baby boom population is expected to increase at a faster rate than any other group under age 65. [Source: Agency for Healthcare Research and Quality, HCUP, Statistical Brief #79: Hospital Utilization among Near-Elderly Adults, Ages 55 to 64 Years, 2007.]
- Second meeting of the Subcommittee on Quality Measures for Children's Healthcare in Medicaid and Children's Health Insurance Program
- Revised Common Formats (Version 1.0) now available for Patient Safety Organizations
- Comparative effectiveness of lipid-modifying agents
- New AHRQ evidence report on the treatment of overactive bladder in women available
- Free tool helps calculate return on investment from better asthma care
- What's new at AHRQ's Health Care Innovations Exchange—medical home and workplace wellness
- AHRQ launches new health care-associated infections resource Web page
- New AHRQ toolkit improves study participant recruitment process
- AHRQ's impact case studies and knowledge transfer case studies are available
- AHRQ in the professional literature
1. Second Meeting of the Subcommittee on Quality Measures for Children's Healthcare in Medicaid and Children's Health Insurance Program
AHRQ is sponsoring a meeting of the National Advisory Council for Healthcare Research and Quality Subcommittee on Quality Measures for Children's Healthcare in Medicaid and Children's Health Insurance Programs on September 17-18 at 8:00 a.m. at the Holiday Inn Capitol, 550 C Street SW, Washington, DC. Review of the results of the second stage of the Delphi Process of scoring measures for validity, feasibility, and importance, and proceed to select an initial core set of children's healthcare quality measures to recommend to the AHRQ National Advisory Committee. This process was started in the first subcommittee meeting, held July 22-23, 2009. Select to access the agenda and to participate via live video Webcast.
2. Revised Common Formats (Version 1.0) Now Available for Patient Safety Organizations
AHRQ has released Version 1.0 of Common Formats for collecting and reporting patient safety information—including adverse events, near misses, and unsafe conditions—in the hospital setting. The revised Common Formats update Version 0.1 beta released in August 2008 that were developed by health agencies within the Federal government. Version 1.0 reflects public input from individuals, provider organizations, and health care associations. Common Formats, which are authorized by the Patient Safety and Quality Improvement Act of 2005 (the Patient Safety Act), establish a standard language, definitions, technical requirements, and reporting specifications that patient safety, quality, and risk managers; clinicians; and others can use to collect patient safety event information. AHRQ's revised Common Formats include descriptions of patient safety events and unsafe conditions to be reported, paper forms delineating data elements to be collected for patient safety events and unsafe conditions, and an updated user's guide. Patient Safety Organizations (PSOs) will use Common Formats to ensure consistency in reporting patient safety event information and allow aggregation and analysis of comparable, interoperable data at provider, PSO, and national levels. AHRQ also plans to release technical specifications, including patient safety population reports, in the first quarter of 2010 that will expedite the development of software to automate the Common Formats. AHRQ also plans to develop Common Formats for other settings, such as nursing homes, ambulatory surgery centers, and physician and practitioner offices. The revised Common Formats and accompanying user information are available at no charge through AHRQ's PSO Web site.
3. Comparative Effectiveness of Lipid-Modifying Agents
AHRQ released a new report that found that there is not yet enough evidence to support the use of so-called "combination therapies" over higher dose statin therapy. The long term clinical benefits and risks of combination therapies have not been demonstrated. Statins can be an invaluable tool in fighting cardiovascular diseases, which afflict more than 28 million Americans and cause more deaths than cancer, diabetes, accidents and chronic lung diseases combined. Statins are generally regarded as a safe and effective means to lower "bad cholesterol" (low density lipoprotein cholesterol, or LDL-c). However, some patients do not respond to a commonly used low dose of statins, so scientists have been interested in whether to increase the dosage of statins alone or combine them with other anti-cholesterol drugs such as fibrates or niacin. Select to access the report.
4. New AHRQ Evidence Report on the Treatment of Overactive Bladder in Women Available
AHRQ released a new evidence report, Treatment of Overactive Bladder in Women, which finds drug therapy and behavior interventions produce modest results in reducing overactive bladder symptoms. Quality of life and satisfaction measures suggest such improvements can be important to women. The review was conducted by AHRQ's Vanderbilt University Evidence-based Practice Center in Nashville, and was requested by the American Urological Association. The research, led by Katherine Hartmann, M.D., Ph.D., reviewed research evidence on treatments for overactive bladder. These treatments include prescription medications, both pills and patches; surgeries and procedures, behavior interventions, and complementary and alternative medicine, such as acupuncture, hypnotherapy and reflexology. Behavioral interventions, which may include pelvic muscle exercises and training the bladder by steadily increasing the time between bathrooms visits, are modestly effective in reducing incontinence associated with overactive bladder syndrome. The results produced by these behavior modifications are similar to the impact of drug therapy. Drug therapy was found to be modestly effective at improving one or more overactive bladder symptoms; however, there is no evidence to determine the long-term effectiveness of the drugs. Researchers found little evidence to support the effectiveness of complementary and alternative therapies. Procedural and surgical treatments, such as sacral nerve stimulation (neuromodulation), and bladder instillation or injections, were found to treat symptoms in select groups of women though more information is needed to understand safety and effectiveness. Select access to the report.
5. Free Tool Helps Calculate Return on Investment from Better Asthma Care
Today, employers are seeking solutions that can help reduce their health care costs without sacrificing the health care services provided to their employees or harming worker productivity. A new online, AHRQ evidence-based tool, called the Asthma Return-on-Investment Calculator, can help you decide whether it is cost effective to establish an asthma care management program for your employees and their families. The tool can be used to calculate how a group of employees could fare under an asthma care management program. For example, if 10,000 privately insured New York employees who visited the hospital emergency department for asthma were enrolled in a care management program, emergency department visits could decrease by about 4,700. This reduction could save close to $1 million in hospital emergency room costs. Once you factor in money saved by not admitting patients to hospitals and decreased use of asthma medications, an additional $4.2 million in savings could be realized. To see how to improve your bottom line by improving asthma care for your employees, check out AHRQ's free tool.
6. What's New at AHRQ's Health Care Innovations Exchange—Medical Home and Workplace Wellness
During the month of September the AHRQ Health Care Innovations Exchange Web site will feature innovative health service delivery profiles and tools in the areas of the Medical Home and the promotion of Workplace Wellness. The site will explore the development of Medical Homes for a variety of populations (low-income, at-risk, special needs, disabled, elderly). On September 16, the site will feature Workplace Wellness innovations and tools that demonstrate the benefits of offering employee health screenings, counseling, and workshops. The Innovations Exchange contains more than 300 searchable innovations and 1,400 searchable QualityTools. Don't forget to visit the Spotlight for expert commentary, human interest stories, and other opportunities to connect with this program. You can access past issues of "What's New" on topics such as mental health, women's health, management of asthma, obese and overweight youth, and culturally competent care.
7. AHRQ Launches New Health Care-Associated Infections Resource Web Page
AHRQ has launched a new Web page that features research initiatives and resources on health care-associated infections (HAIs) for consumers and health care professionals. Information from AHRQ, CDC, CMS, HHS' Office of Public Health and Science's National Action Plan on HAIs, and other resources focused on preventing and reducing HAIs are listed. Resources for health care providers, including links to the Michigan Keystone Project that features the Comprehensive Unit-based Safety Program for reducing infections and the Johns Hopkins central line insertion care team checklist. Other resources from the World Health Organization, the American Health Quality Association, the Association for Professionals in Infection Control and Epidemiology, and the Society for Healthcare Epidemiology of America are featured. We also feature links to relevant AHRQ consumer advice columns, press releases, and congressional hearings and testimony. Select to access the new AHRQ HAI Web page.
8. New AHRQ Toolkit Improves Study Participant Recruitment Process
AHRQ has a free toolkit to help researchers obtain potential research participants' informed consent and authorization to use their health data in accordance with the Privacy Rule of the Health Insurance Portability and Accounting Act (HIPAA). The toolkit provides information on how to ensure that people of all health literacy levels understand what studies entail and to what they are consenting when they agree to participate. AHRQ developed the toolkit because researchers often use long consent forms that potential study participants can find difficult to comprehend. Research also shows that a large proportion of study participants did not understand what they had consented to when they joined a study. There is evidence that Institutional Review Boards often fail to meet their own standards for the reading level of consent and data-use forms. The AHRQ Informed Consent and Authorization Toolkit for Minimal Risk Research, which was developed by AHRQ and tested by researchers from Boston University, includes recommendations for improving the informed consent and authorization process; sample consent and HIPAA authorization documents in English and Spanish; recommendations for adapting and testing the documents; statutory requirements and exceptions; and a tool for researchers' certification of consent and authorization. Select to access the toolkit.
9. AHRQ's Impact Case Studies and Knowledge Transfer Case Studies Are Available
AHRQ's Impact Case Studies and the Knowledge Transfer Case Studies are now available on the AHRQ Web site. Impact Case Studies Program catalogues the impact the Agency's research and resources have on outcomes, quality, cost, use, and access. They demonstrate how AHRQ-funded research, tools, and products are actually being used by Federal and State Government; individual practices, clinics, and hospitals; insurance companies; professional associations; and schools of public health and medicine. Knowledge Transfer Case Studies describe results of activities under AHRQ's Knowledge Transfer and Implementation contract program, which is intended to accelerate the dissemination and implementation of AHRQ's evidence-based products, tools, and research findings into the health care system. Select to access the impact case studies categorized by the agency's research portfolios.
10. 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.
Keyhani S, Kleinman LC, Rothschild M, et al. Overuse of tympanostomy tubes in New York metropolitan area: evidence from five hospital cohort. BMJ 2008 Oct 3; 337:a1607. Select to access the abstract.
Hedayati SS, Bosworth HB, Briley LP, et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int 2008 Oct; 74(7):930-6. Select to access the abstract.
Skolasky RL, Mackenzie EJ, Wegener ST, et al. Patient activation and adherence to physical therapy in persons undergoing spine surgery. Spine 2008 Oct 1; 33(21):E784-91. Select to access the abstract.
Kritchevsky SB, Braun BI, Bush AJ, et al. The effect of a quality improvement collaborative to improve antimicrobial prophylaxis in surgical patients: a randomized trial. Ann Intern Med 2008 Oct 7; 149(7):472-80, W89-W93. Select to access the abstract.
Hwang SW, Colantonio A, Chiu S, et al. The effect of traumatic brain injury on the health of homeless people. CMAJ 2008 Oct 7; 179(8):779-84. Select to access the abstract.
Sabin JE, Mazor K, Meterko V, et al. Comparing drug effectiveness at health plans: the ethics of cluster randomized trials. Hastings Cent Rep 2008 Sep-Oct; 38(5):39-48. Select to access the abstract.
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Current as of September 2008
AHRQ Electronic Newsletter, September 11, 2009, Issue #281. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews281.htm