Routine Osteoporosis Screening Recommended for All Women Over Age 65

Roughly 60 million people—1 in 5 Americans—have no usual source of medical care, such as a family doctor or clinic. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #308: Main Reason for Not Having a Usual Source of Care: Differences by Race/Ethnicity, Income, and Insurance Status, 2007]

Today's Headlines

1. Routine osteoporosis screening recommended for all women over age 65
2. AHRQ researchers find that inpatient operating room procedures account for nearly half of hospitals' treatment costs
3. 2010 John M. Eisenberg Patient Safety and Quality Award recipients announced
4. New look for AHRQ's Health Care Innovations Exchange Web site
5. New issue features innovations on the benefits of using phone-based care management
6. Registration now open for the Medicare and Medicaid EHR Incentive programs and Medicaid payments have already been issued by two States
7. Prevention of falls in older adults
8. Call for abstracts to participate in an AHRQ Research Methods Symposium on Patient-Centered Outcomes
9. AHRQ in the professional literature

1. Routine Osteoporosis Screening Recommended for All Women Over Age 65

In an update to its 2002 recommendation, the U.S. Preventive Services Task Force (USPSTF) now recommends screening for osteoporosis in women ages 65 years and older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. White women are used as the benchmark because they have a markedly higher rate of osteoporosis and fractures than other ethnic groups. The Task Force also concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis in men. This is the first final recommendation statement to be published since the implementation of the USPSTF public comment process for draft recommendation statements. The recommendation appeared in the January 18 online issue of the Annals of Internal Medicine and is also available on the USPSTF Web site. Select to read our press release.

2. AHRQ Researchers Find That Inpatient Operating Room Procedures Account For Nearly Half of Hospitals' Treatment Costs

Although only a quarter of patient stays in U.S. hospitals in 2007 involved procedures that were conducted in operating rooms, such stays accounted for 47 percent of hospitals' costs—a total of $161 billion for patients receiving procedures, according to a new study by AHRQ researchers that was published in the December 2010 issue of the Archives of Surgery. The researchers found that one-third of the 15 million operating room procedures that year involved people age 65 and older and that older patients were two to three times more likely to undergo surgery than younger patients. Surgical patients tended to be less severely ill than non-surgical patients, but their daily cost was double—$2,900 versus $1,400 a day. Fifteen procedures accounted for half of hospitals' costs for surgical patient stays and one-quarter of overall hospital costs. Four of the most expensive procedures—angioplasty, cesarean section delivery, knee replacement and spinal fusion—increased in volume by between 20 percent and 46 percent between 1997 and 2007, while heart bypass surgery plummeted by 70 percent. More than half of all procedures were elective. According to AHRQ researchers and study authors, Anne Elixhauser, Ph.D., and Roxanne M. Andrews, Ph.D., the findings highlight the important role that inpatient surgical procedures play in U.S. health care. The study is based on data in AHRQ's Nationwide Inpatient Sample, a database of hospital inpatient stays in short-term, nonfederal hospitals, which includes all patients, regardless of their type of insurance type, as well as the uninsured. Select to access the abstract on PubMed.®

3. 2010 John M. Eisenberg Patient Safety and Quality Award Recipients Announced

The National Quality Forum and the Joint Commission on Accreditation of Healthcare Organizations announced the 2010 recipients of the annual John M. Eisenberg Patient Safety and Quality Awards. The honorees, by award category, were for Individual Achievement: John H. Eichhorn, M.D., University of Kentucky, Lexington, KY; and James L. Reinertsen, M.D., The Reinertsen Group, Alta, WY; Innovation in Patient Safety and Quality at the National Level: Washington State Hospital Association, Seattle, WA; and Innovation in Patient Safety and Quality at the Local Level: The Children's Hospital at Providence Newborn Intensive Care Unit, Anchorage, AK. Select to read the National Quality Forum press release.

4. New Look for AHRQ's Health Care Innovations Exchange Web Site

A redesign of AHRQ's Health Care Innovations Exchange Web site now provides more information and offers a more interactive experience for users. Highlights of the redesigned site include:

• A new homepage that makes main content areas more visible and accessible.
• An updated Browse-by-Subject feature that allows you to narrow the topic to reach innovations and/or tools of interest.
• Photos that rotate with issues and videos that enhance your multimedia experience.
• Social media links, such as Twitter, that enable you to stay connected.

5. New Issue Features Innovations on the Benefits of Using Phone-Based Care Management

In this week's spotlight, AHRQ's Health Care Innovations Exchange Web Site features an article on the benefits of using phone-based care management to help reduce medical costs and lead to improved patient care, medication adherence, and patient satisfaction. The featured innovations used a telephone-based approach to deliver care to specific patient populations. There are also quality tools to help clinicians better understand the use of telephone care to manage specific conditions. To find out more about these phone-based care management innovations and more visit the AHRQ Health Care Innovations Exchange Web site.

6. Registration Now Open for the Medicare and Medicaid EHR Incentive Programs and Medicaid Payments Have Already Been Issuedby Two States

The first payments under the Medicaid Electronic Health Record (EHR) Incentive Program were issued by Oklahoma and Kentucky. Kentucky processed payment to the University of Kentucky's teaching hospital, University of Kentucky Healthcare. The first payment, $2.86 million, was one-third of the hospital's overall expected amount for participating in the program. Oklahoma issued payments to two physicians at the Gastorf Family Clinic of Durant, OK, for $21,250 each, for having adopted certified electronic health records. These incentive payments for the adoption of certified EHR technology are funded under the federal Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009. For more information on the Medicare and Medicaid Electronic Health Records Incentive Programs, please visit CMS' EHR Web site.

7. Prevention of Falls in Older Adults

The U.S. Preventive Services Task Force is inviting public comment on its draft recommendation statement on the prevention of falls in older adults. This is the first time since 1996 that the Task Force is making a recommendation on this topic. Select to provide comments. The opportunity to comment on this draft recommendations statement is available until February 9.

8. Call for Abstracts to Participate in an AHRQ Research Methods Symposium on Patient-Centered Outcomes

AHRQ's Effective Health Care Program is accepting abstract submissions for an invitational symposium on research methods for comparative effectiveness and patient-centered outcomes research. The symposium is a follow-up to the 2006 and 2009 AHRQ conferences on Methods in Comparative Effectiveness Research. Papers presented at past conferences were published in the journal Medical Care and can be freely downloaded. The theme of the 2011 conference is "Methods for Developing and Analyzing Clinically Rich Data for Patient-Centered Outcomes Research." Authors of abstracts that are selected for the symposium will be invited to present their work at the symposium and to submit a complete manuscript for peer-review and publication in a special journal supplement. Submissions are due by March 1.

9. 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.

Toledo P, McCarthy RJ, Burke CA, et al. The effect of live and Web-based education on the accuracy of blood-loss estimation in simulated obstetric scenarios. Am J Obstet Gynecol 2010 Apr; 202(4):400.e1-400.e5. Select to access the abstract on PubMed.®

Hsu DJ, Stone RA, Obrosky DS, et al. Predictors of timely antibiotic administration for patients hospitalized with community-acquired pneumonia from the cluster-randomized EDCAP trial. Am J Med Sci 2010 Apr; 339(4):307-13. Select to access the abstract on PubMed.®

Cohen A, Rabbani A, Shah N, Alexander GC. Changes in glitazone use among office-based physicians in the U.S., 2003-2009. Diabetes Care 2010 Apr; 33(4):823-5. Select to access the abstract on PubMed.®

Mennito SH, Darden PM. Impact of practice policies on pediatric immunization rates. J Pediatr 2010 Apr; 156(4):618-22. Select to access the abstract on PubMed.® Routh JC, Gong EM, Cannon GM Jr, et al. Variation among Internet based calculators in predicting spontaneous resolution of vesicoureteral reflux. J Urol 2010 Apr; 183(4):1568-72. Select to access the abstract on PubMed.®

Howell EA, Mora PA, Chassin MR, et al. Lack of preparation, physical health after childbirth, and early postpartum depressive symptoms. J Womens Health 2010 Apr; 19(4):703-8. Select to access the abstract on PubMed.®

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