June 10, 2004, Issue No. 137
AHRQ News and Numbers
Working people ages 16 and over had lower out-of-pocket dental expenses in
2000 than people who were not employed ($174 for employed people versus $256 for
unemployed people). Average out-of-pocket expenses for people with at least one
dental visit were highest in the Northeast and lowest in the Midwest, although
people in the Midwest, West, and South experienced substantial increases in
their average out-of-pocket dental expenses (from $139 to $204 in the Midwest,
$194 to $240 in the West, and $202 to $245 in the South) between 1996 and 2000.
[Source: Agency for Healthcare Research and Quality, MEPS Research Findings
#20: Dental Services: Use, Expenses, and Sources of Payment, 1996-2000.]
Today's Headlines:
- Children frequently experience medical injuries in
hospitals
- Call for nominations for new class of Patient Safety
Improvement Corps
- Free Webcast on updating CAHPS® ambulatory surveys set for
June 24
- Translating Research Into Practice conference scheduled July
12 - 14 in Washington, DC
- Medical errors article in Parade magazine
- New AHRQ evidence report helps hospitals respond to
bioterrorism or other public health emergencies
- More research needed on use of NSAIDs for cancer pain
relief
- AHRQ study on hospital admissions for HIV disease
complications
- AHRQ-NEH conference summary is available
- Fact sheets on closing the quality gap are available
- New features available on NGC and NQMC
- AHRQ in the professional literature
1. Children Frequently Experience Medical Injuries in Hospitals
A new AHRQ-funded study shows that children often experience adverse patient
safety events-such as medical injuries or errors-in the course of hospital care,
with those in vulnerable populations, including children under 1 year old, at
highest risk. The study, "Pediatric Patient Safety in Hospitals: A National
Picture in 2000," was led by Marlene R. Miller, M.D., from Johns Hopkins
Children's Center. Dr. Miller and her colleagues used AHRQ's recently developed
Patient Safety Indicators to focus on children in hospitals. They examined 5.7
million hospital discharge records for children under age 19 from 27 states that
were drawn from AHRQ's 2000 HCUP State Inpatient Databases. This is one of the
first studies to quantify the impact of patient safety events on children in
terms of excess hospital stays and charges, as well as the increased risk of
death among children due to medical errors. Another AHRQ-funded study,
"Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care,"
by Gautham Suresh, M.D., of the University of Vermont's Center for Patient
Safety in Neonatal Intensive Care, found that when a specialty-based, voluntary,
anonymous Internet reporting system for identifying medical errors in neonatal
intensive care was implemented, a significant number of medical errors were
identified. Both articles appeared in the June issue of Pediatrics.
Select to read the press release.
2. Call for Nominations for New Class of Patient Safety
Improvement Corps
AHRQ, in partnership with the Department of Veterans Affairs' National Center
for Patient Safety, is continuing to support a training program called the
Patient Safety Improvement Corps. Its purpose is to train teams of state health
officials and their selected private or public hospital partners in analyzing
reported medical errors, identifying their root causes, and developing and
implementing interventions to improve patient safety. The program is free, and
the cost of travel and lodging is reimbursed. The new class is scheduled to
begin September 21. E-mail notification of intent to submit is due June 30, and
applications for participation in the program must be submitted by July 30.
Applications must be submitted by state departments of health or other state
organizations dealing with the reporting and analysis of medical errors,
although teams may be made up of state staff and their selected hospital partner
staff. Select to access more information.
3. Free Webcast on Updating CAHPS® Ambulatory Surveys Set for June 24
AHRQ and the CAHPS® Survey Users Network (SUN) are sponsoring a free Webcast
on Thursday, June 24 from 1:00 - 3:00 p.m. ET about a new initiative to develop
a suite of CAHPS® surveys that cover all levels of ambulatory care. This
Webcast, "Updating CAHPS®: Consumer Surveys for Doctors, Groups, and Health
Plans," offers a look inside the development of new CAHPS® surveys that are
being designed to meet the needs of health plans, providers, purchasers, and
consumers. You'll learn:
- What the CAHPS® ambulatory surveys will be.
- How these surveys will meet your information needs.
- Why the current CAHPS® Health Plan and Group Practice Surveys are being
updated.
- How these new or refined instruments will influence future survey projects.
- How the development process works and the role you can play in providing
input.
4. Translating Research Into Practice Conference Scheduled July
12-14 in Washington, DC
Mark your calendars for TRIP 2004, "Translating Research Into Practice:
Advancing Excellence from Discovery to Delivery." This expanded July 12-14
conference at the new Washington, DC, Convention Center, will examine the
state-of-the-art and next horizons in implementing research in clinical practice
and health policy. AHRQ Director Carolyn Clancy, M.D., and National Health
Information Technology Coordinator David Brailer, M.D., Ph.D., are among the
keynote speakers, and sessions will focus on knowledge transfer related to
ephedra, colorectal and prostate cancer screening, and tobacco cessation
interventions for underserved populations. Health care provider organizations,
clinicians, patients, purchasers, researchers, innovators, knowledge transfer
experts, and others from across the public and private sectors will share
research, insights, collaborations, and initiatives for moving knowledge of
efficacy and effectiveness into sustained practice change.
5. Medical Errors Article in Parade
Magazine
AHRQ Director Carolyn Clancy, M.D., was featured in an article on avoiding
medical errors entitled "How You Can Protect Yourself" that was published in the
May 23 issue of Parade magazine. Select to read the article.
6. New AHRQ Evidence Report Helps Hospitals Respond to
Bioterrorism or Other Public Health Emergencies
As part of its public health and emergency preparedness portfolio, AHRQ has
released the new evidence report, Training of Hospital Staff to Respond to a
Mass Casualty Incident. Developed by AHRQ's Johns Hopkins University
Evidence-based Practice Center in Baltimore, the new report is a followup to a
2002 report entitled Training of Clinicians for Public Health Events Relevant
to Bioterrorism Preparedness. It identifies key elements to be used in
evaluating hospital disaster drills. The new evidence report provided the
science behind another recently released AHRQ tool entitled Evaluation of
Hospital Disaster Drills: A Module-Based Approach. Select to access the
evidence report and the evaluation modules.
7. More Research Needed on Use of NSAIDs for Cancer Pain
Relief
The World Health Organization method for cancer pain relief says that
treating pain with medication should begin with non-steroidal anti-inflammatory
drugs (NSAIDs) before trying opioids. Although many NSAIDs are available, it is
unclear which medication is best for relieving cancer-related pain, and if there
are clinical differences between them that justify their cost differences,
according to a new AHRQ study. Additionally, it is uncertain which opioid and
NSAID combinations are the most beneficial to treat cancer pain or even what may
be the additional benefit to cancer patients of combining an NSAID with an
opioid. Researchers led by Ewan McNicol, R.Ph., of AHRQ's New England Medical
Center Evidence-based Practice Center, encourage more specific research to
better answer these questions. The article, "Nonsteroidal Anti-Inflammatory
Drugs, Alone or Combined with Opioids, for Cancer Pain: A Systematic Review,"
was published in the May 15 issue of the Journal of Clinical Oncology.
Select to read the abstract.
8. AHRQ Study on Hospital Admissions for HIV Disease
Complications>
A new AHRQ eight-state study found that hospital admissions for HIV disease
complications between 1996 and 2000 decreased the most in those states where
low-income people had the least difficulty obtaining expensive anti-retroviral
drugs, and conversely, they declined the least in those states where people
tended to have the most difficulty accessing the drugs. For example, in Florida
and South Carolina, HIV disease hospital admissions declined only 11 percent and
13 percent, respectively, during the 4-year period, compared with declines of
roughly 42 percent in New York, 39 percent in Pennsylvania, and 35 percent in
New Jersey—states where poor patients had less trouble obtaining medications.
Average hospital lengths of stay also varied, ranging from 10 days in New York
in 2000 to 6 days in Colorado. That same year, the cost of an HIV hospital stay
in California in 2000 averaged nearly $2,979 less than the cost of a similar
stay in New York, while in Colorado the cost averaged nearly $4,000 less than
New York. The study by AHRQ's Fred Hellinger, Ph.D., "HIV Patients in the HCUP
Database: A Study of Hospital Utilization and Cost," was published in the June 2
issue of Inquiry. A print copy of the article is available by sending an E-mail to ahrqpubs@ahrq.gov.
9. AHRQ-NEH Conference Summary Is Available
AHRQ has released a new conference summary report, "Setting a Research Agenda
for Health and the Humanities." The National Endowment for the Humanities (NEH)
and AHRQ convened a conference to explore how expanded interaction between
health services researchers and scholars in the humanities might broaden the
horizons of health care in America. This report summarizes the recommendations
from the conference. The majority of the participants felt that a collaborative
research agenda depends on finding ways to introduce and fund truly
interdisciplinary rather than multidisciplinary research. In addition to the
group as a whole, the conference had four specific workgroups: end-of-life
issues, family caregivers, patient safety, and access to care. Two overarching
conference recommendations were to initiate a "big picture" analysis of health
care and to empower a national summit conference or continuing task force to
identify and examine major issues. A print copy of the report is available by
sending an E-mail to ahrqpubs@ahrq.gov.
10. Fact Sheets on Closing the Quality Gap Are
Available
Three new AHRQ fact sheets on closing the quality gap based on reviews
conducted by AHRQ's Evidence-based Practice Center at the University of
California, San Francisco/Stanford are now available. The first, Closing the
Quality Gap: A Critical Analysis of Quality Improvement Strategies, explores
the challenges of translating research into clinical practice. The second and
third fact sheets, Closing the Quality Gap: Diabetes Care Strategies and
Closing the Quality Gap: Hypertension Care Strategies focus on improving
the treatment of patients with these conditions. Select to read our fact sheets. Print copies are
available by sending an E-mail to ahrqpubs@ahrq.gov.
11. New Features Available on NGC and NQMC
The National Guideline Clearinghouse™
(NGC) and the National Quality Measures Clearinghouse™ (NQMC) Web site, two AHRQ-sponsored
online public resources, are now providing a complete summary of each guideline and measure,
respectively, in portable document format (PDF) versions that can be downloaded
and viewed on all computers that use Adobe®Acrobat Reader®. These versions may
also be downloaded to personal digital assistants (PDAs) that can read PDF
files.
12. 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.
Plantinga LC, Fink NE, Sadler JH, et al. Frequency of patient-physician
contact and patient outcomes in hemodialysis care. J Am Soc Nephrol 2004
Jan;15(1):210-8. Select to access the abstract
on PubMed®.
Lan YT, Chang RK, Laks H. Outcomes of patients with double-inlet left
ventricle or tricuspid atresia with transposed great arteries. J Am Coll
Cardiol 2004 Jan 7;43(1):113-9. Select to access the abstract
on PubMed®.
Zhou XH, Castelluccio P. Adjusting for non-ignorable verification bias in
clinical studies for Alzheimer's disease. Stat Med 2004 Jan 30;221-30.
Select to access the abstract
on PubMed®.
Allen EC, Manuel JC, Legault C, et al. Perception of child vulnerability
among mothers of former premature infants. Pediatrics 2004 Feb;113(2):267-73.
Select to access the abstract
on PubMed®.
Corser WD. Postdischarge outcomes rates influenced by comorbidity and
interdisciplinary collaboration. Outcomes Manag 2004 Jan-Mar;8(1):45-51.
Select to access the abstract
on PubMed®.
Phillips KA, Haas JS, Liang SY, et al. Are gatekeeper requirements associated
with cancer screening utilization? Health Serv Res 2004 Feb;39(1):153-78.
Select to access the abstract on PubMed®.
Pronovost PJ, Weast B, Bishop K, et al. Senior executive adopt-a-work unit: a
model for safety improvement. Jt Comm J Qual Saf 2004 Feb;30(2):59-68.
Select to access the abstract
on PubMed®.
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Current as of June 2004
Internet Citation:
AHRQ Electronic Newsletter. June 10, 2004, Issue No. 137.
Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews137.htm
540 Gaither Road Rockville, MD 20850