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Electronic Newsletter

February 16, 2007, Issue No. 221

AHRQ News and Numbers

Heart disease, stroke, deep vein thrombosis and other diseases involving the circulatory system accounted for nearly 7 million hospital stays in 2004—one of every six stays. Only pregnancy and childbirth accounted for more stays. [Source: Agency for Healthcare Research and Quality (AHRQ), HCUP Statistical Brief No. 26: Hospital Stays for Circulatory Diseases, 2004].

Today's Headlines:

1. AHRQ's FY 2008 Budget Request is $329.6 Million
2. AHRQ's Podcast Features Story on Second-Generation Antidepressants
3. AHRQ Releases Updated and New CAHPS® Surveys
4. Latest Issue of AHRQ WebM&M Available Online
5. Call for Nominations for 2007 John M. Eisenberg Patient Safety and Quality Awards
6. Highlights from Our Most Recent Monthly Newsletter
7. AHRQ in the Professional Literature

1. AHRQ's Fiscal Year 2008 Budget Request is $329.6 Million

AHRQ's fiscal year (FY) 2008 budget request is $329.6 million, an increase of $10.9 million or 3.4 percent from the FY 2007 continuing resolution level. Specifically, the FY 2008 request for patient safety research is $93.9 million, an increase of $9.9 million, or 11.8 percent from the FY 2007 continuing resolution level. This includes $3.4 million in new health information technology grants and $2.5 million in new patient safety grants. It is expected that these new grants will build on proposals developed for AHRQ's FY 2007 ambulatory patient safety program.

The FY 2008 budget request also proposes a new Personalized Healthcare Initiative funded at $15 million. Non-patient safety research totals $235.6 million, an increase of $0.9 million. The request will provide $3.7 million to support 42 new grants that will continue research in AHRQ's 3 strategic plan goal areas and 10 research portfolios of work. Support for non-patient safety contracts totals $84.8 million, an increase of $4 million from the FY 2007 continuing resolution level. Of this increase, $3.7 million will support contracts related to the Department of Health and Human Services' (HHS) Value-driven Health Care Initiative.

AHRQ's Medical Expenditure Panel Survey (MEPS) is funded at $55.3 million, maintaining the same level of support as the FY 2007 continuing resolution level. In addition, the FY 2008 request for the Effective Health Care Program continues AHRQ's $15 million investment. Select for more information on AHRQ's FY 2008 budget request (PDF Help).

2. AHRQ's Podcast Features Story on Second-Generation Antidepressants

This week's Healthcare 411 audio podcast features Brad Gaynes, M.D., a psychiatrist and member of a panel that conducted a review of second-generation antidepressants as part of AHRQ's Effective Health Care Program. The research found that most of these second-generation antidepressants are equally effective, although they differ in terms of side effects.

Dr. Gaynes also stressed that no drug is going to work for every person, and if at first one doesn't work, patients should work with their doctors to try another, and possibly another, until they find one that does work. The 10½-minute podcast also includes stories about new data on hospitalizations for congenital disorders and an evidence report about health care-associated infections. Select to access the audio podcast.

You can listen to the audio program directly through your computer—if it has a sound card and speakers and can play MP3 audio files—or you can download it to a portable audio device. In any case, you will be able to listen at your convenience. To access any of AHRQ's podcasts and special reports or to sign up for a free subscription to the series to receive notice of all future AHRQ podcasts, visit our Healthcare 411 series main page.

3. AHRQ Releases Updated and New CAHPS® Surveys

AHRQ's CAHPS® Consortium recently released the newest version of the CAHPS® Health Plan Survey 4.0. This updated survey instrument features a more streamlined structure, greater clarity in question wording, and a stronger focus on essential health plan functions.

In collaboration with Centers for Medicare & Medicaid Services (CMS), the consortium also released the new CAHPS® In-Center Hemodialysis Survey, which asks patients about their experiences with care at dialysis facilities. This instrument is expected to help dialysis facilities and networks evaluate the quality of care they provide and gather information needed for quality improvement initiatives. Select for information on CAHPS® surveys. Both questionnaires are packaged in CAHPS® Survey and Reporting Kits, which also include guidelines on preparing and administering the surveys, sample notification letters and telephone scripts, and analysis programs and instructions. Select to access the CAHPS® kits.

4. Latest Issue of AHRQ WebM&M Available Online

The February issue of AHRQ WebM&M is available online. This month, the Perspectives on Safety section looks at diagnostic errors in medicine. Mark Graber, M.D., vice chairman, academic affairs, State University of New York at Stony Brook, offers his perspective on what doctors and umpires have in common when it comes to decisionmaking. There also is an interview with Joseph Britto, M.D., CEO, and co-founder of Isabel Healthcare, a clinical decision support system designed to enhance the quality of diagnosis decisionmaking.

In the first Spotlight Case, a parent brings her 18-month-old into the clinic with multiple complaints, including rash, diarrhea, and concern for fracture due to a fall. The child is sent home with a diagnosis of viral syndrome. Later, still concerned about her child's gait, the mother takes her to the emergency department, where an x-ray reveals a fractured tibia. The commentary, authored by Niraj Sehgal, M.D., assistant professor of medicine at the University of California, San Francisco, discusses patient-centered care and its relationship to safety, quality, and patient satisfaction. In the second case, a woman admitted to the hospital for cardiac transplantation evaluation is mistakenly given warfarin despite an order to hold the dose due to an increase in her international normalized ratio level. In the third case, in an urgent care clinic, a 5-year-old with fever and sore throat receives a rapid strep test, which is negative. Later, the child seems worse, and the father takes her to the emergency department, where another rapid strep test is strongly positive for group A streptococcal infection. Commentary authors are Steven Kayser, Pharm.D., of the University of California, San Francisco, and Edward Kaplan, M.D., of the University of Minnesota Medical School.

A Spotlight slide presentation is available for download. As always, you can receive continuing medical education (CME), continuing education units (CEU), or trainee certification by taking the Spotlight Quiz. All previously published commentaries are available under the "Case Archive" section. Please submit cases to AHRQ WebM&M via the "Submit Case" button.

5. Call for Nominations for 2007 John M. Eisenberg Patient Safety and Quality Awards

The Joint Commission and the National Quality Forum are now accepting nominations for the 2007 John M. Eisenberg Patient Safety and Quality Awards, which recognize individuals and health care organizations that are making significant contributions to improving health care quality and patient safety. The deadline for submission is April 16.

6. Highlights from Our Most Recent Monthly Newsletter

Among the key articles in the online issue of Research Activities:

American Indians and Alaska Natives are difficult to reach by mail for research or health care reasons.
It is difficult to reach by mail the 4 million American Indians and Alaska Natives who live in the United States to involve them in research or their own health care. In this AHRQ-funded study, researchers sent a Native art calendar via first class mail to patients who had been seen at the clinic during the prior 2 years. Based on initial mailings and in-person location efforts, only an estimated 61 percent of patients received the calendars. Select to review this article.