May 31, 2007, Issue No. 330
AHRQ News and Numbers
Men were less likely to be hospitalized for prostate cancer treatment in 2004 than in 1997. Hospitalizations for treatment of the disease fell nearly 30 percent in those 8 years. In 2004, hospitals charged $1.7 billion for the stays of patients admitted for prostate cancer treatment. Almost half of this amount was billed to private insurers; 43 percent was billed to Medicare; 4 percent was billed to Medicaid; 1.5 percent was billed to uninsured patients and the remainder was charged to other payers such as the Veterans Administration, military or other State programs. (Source: Agency for Healthcare Research and Quality (AHRQ) Hospital Stays for Prostate Cancer, 2004, HCUP Statistical Brief No. 30)(PDF Help).
Today's Headlines:
1. New Web Tool Provides Samples of Report Cards on Health Care Quality
2. Small Infants Have Greater Survival Rate in High-Level Intensive Care Facilities
3. New Evidence Report on Use of Gene-Based Testing in Hereditary Nonpolyposis Colorectal Cancer Is Available
4. Latest AHRQ Healthcare 411 Podcast Features Story on Mistake-Proofing
5. Lower Infection Rates for Elderly Patients Found at Better Staffed Hospital ICUs
6. Register to Attend AHRQ and FDA Public Workshop on the Use of Risk Minimization Action Plans for High-Risk Medications
7. AcademyHealth's Call for Nominations for Health Services Research Impact Award
8. AHRQ in the Professional Literature
1. New Web Tool Provides Samples of Report Cards on Health Care Quality
With rising interest in information about the quality of care delivered by health care providers, AHRQ has developed a new Web tool demonstrating a variety of approaches for health quality report cards.
The new Health Care Report Card Compendium is a searchable directory of over 200 samples of report cards produced by a variety of organizations. The samples show formats and approaches for providing comparative information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care.
The purpose of the AHRQ Report Card Compendium is to inform and support the various organizations that develop health care quality reports, to provide easy access to examples of different approaches to content and presentation, and to meet the needs of health services researchers. It also provides related Web sites and sample pages where available. Select to review our press release, or select to access the Health Care Report Card Compendium.
2. Small Infants Have Greater Survival Rate in High-Level Intensive Care Facilities
AHRQ and the National Institutes of Health's (NIH) National Institute of Child Health and Human Development released new findings that show that very low birth weight infants are significantly more likely to survive when delivered in hospitals with high-level neonatal intensive care units (NICUs) that care for more than 100 of these newborns annually than are those delivered in comparable facilities that provide care to fewer than 100 of these children every year. Very low birth weight infants are those weighing less than 1500 grams, or about 3.3 pounds, at birth.
Very low birth weight infants are highly vulnerable to medical complications. In 2000, these infants comprised just 1.4 percent of U.S. births but 51 percent of infant deaths. The latest research indicates some of these newborn deaths may be preventable. The researchers, led by Ciaran Phibbs, Ph.D., health economist at the Health Economics Resource Center at the Veterans Affairs Palo Alto Health Care System and associate professor at the Department of Pediatrics at Stanford University, reported that less than a quarter of very low birth weight infants are born in hospitals with high-level, high-volume NICUs, and this percentage has been declining over time. The study examined differences in death rates across hospitals with different NICU levels and their volume (how many very low birth weight infants they care for in a year).
Despite the increased survival rate for very low birth weight infants in large, high-level NICUs, the researchers found that an increasing number of high-risk newborns are receiving care in low-volume, mid-level units. The study appeared in the May 24 issue of the New England Journal of Medicine. Select to review the press release, or select to access the abstract in PubMed®.
3. New Evidence Report on Use of Gene-Based Testing in Hereditary Nonpolyposis Colorectal Cancer Is Available
AHRQ released a new evidence report that finds there is little published evidence on the accuracy and reliability of laboratory testing used to diagnosis Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HPNCC), in colorectal cancer patients or their family members. The laboratory tests analyze tumor or blood cells to look for mutations in DNA mismatch repair genes, which are proteins that fix mistakes in DNA made for new cells. Most patients with colorectal cancer do not have gene mutations.
The results of a computer model showed that identification of HPNCC in high-risk patients by evaluating for three risk factors (age less than 50, history of colon or endometrial cancer in a first-degree family member, and presence of multiple cancers in the patient) and then analyzing the tumor tissue may potentially be as effective as other strategies, while reducing the number of tests. The evidence report is the first step in the two-step process of CDC's Evaluation of Genomic Applications in Practice and Prevention (EGAPP) pilot project to evaluate and make recommendations regarding the use of gene-based tests.
The EGAPP working group, an independent, non-Federal panel, will issue recommendations on the use of these tests in the diagnosis and treatment of hereditary nonpolyposis colorectal cancer based on the evidence report and other considerations, including alternative approaches for screening and diagnosis, patient access to testing, and cost. The report was prepared by AHRQ's Tufts-New England Medical Center Evidence-based Practice Center. Select to review the report (PDF Help). A print copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.
4. Latest AHRQ Healthcare 411 Podcast Features Story on Mistake-Proofing
AHRQ's latest Healthcare 411 audio podcast features comments on mistake-proofing in health care from John R. Grout, Ph.D., the newly appointed dean of Berry College's Campbell School of Business. Dr. Grout produced a synthesis for AHRQ of ways to improve patient safety by making simple changes in health care settings.
The 12-minute podcast also includes stories about HCUP data on traumatic brain injury and the release of AHRQ's new handbook for creating and operating patient registries. Select to access the audio podcast, or select to access Dr. Grout's synthesis, Mistake-Proofing the Design of Health Care Processes.
You have the option of listening 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 either 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 and receive notice of all future AHRQ podcasts, visit our Healthcare 411 series main page.
5. Lower Infection Rates for Elderly Patients Found at Better Staffed Hospital ICUs
Hospitals with better working conditions for nurses are also safer for elderly patients in intensive care units (ICUs), according to a new AHRQ-funded study. A review of outcomes data for more than 15,000 patients in 51 U.S. ICUs found that those with high nursing staffing levels, or an average of 17 registered nurse hours per day, had a lower incidence of hospital-associated infections. In contrast, higher levels of overtime were associated with increased rates of infection and skin ulcers.
Hospital-associated infections are the sixth-leading cause of death in the United States, according to the Centers for Disease Control & Prevention (CDC). Researchers at Columbia University also found that ICUs with higher staffing had lower incidence of central line-associated bloodstream infections, a common cause of mortality in intensive care settings. Other measures such as ventilator-associated pneumonia and skin ulcers were also reduced in units with high staffing levels. Patients were also less likely to die within 30 days in higher staffed units. The study, "Nurse Working Conditions and Patient Safety Outcomes," was published in the June 2007 issue of Medical Care. Select to access the abstract in PubMed®.
6. Register to Attend AHRQ and FDA Public Workshop on the Use of Risk Minimization Action Plans for High-Risk Medications
Registration is now open for a 2-day public workshop, sponsored by AHRQ and the Food and Drug Administration (FDA), to gather input on medication risk minimization action plans from clinicians, patients, caregivers, third-party payers, the pharmaceutical and biotechnology industries, researchers, and innovators in health information technology. The workshop, entitled "Implementation of Risk Minimization Action Plans (RiskMAPs) to Support Quality Use of Pharmaceuticals: Opportunities and Challenges", will be held on June 25 and 26, here at AHRQ.
To manage the available space and building security requirements, advance registration is required. Individuals who want to speak during the open public comment period should register by June 8; all others must register by June 15. Registration information can be obtained by sending an E-mail to register@consolidatedsafety.com or by calling (703) 877-3345. Space is available on a first-come-first-served basis. Select for more information, or select to review the Federal Register announcement and submit comments.
7. AcademyHealth's Call for Nominations for Health Services Research Impact Award
AcademyHealth has issued a call for nominations for the third annual Health Services Research Impact Award, which recognizes outstanding research that has been successfully translated into health policy, management, or clinical practice and, as a result, had a positive impact on health and health care. The lead researcher of the winning impact will receive $2,000, and the research will be disseminated widely as part of AcademyHealth's ongoing efforts to promote the field of health services research and communicate its value for health care decision-making.
The award will be announced at the 2008 National Health Policy Conference on February 4-5, and the winner will receive $2,000, complimentary registration, travel, and lodging to the conference. The deadline for nominations is July 31. Visit the AcademyHealth Web site for more information on eligibility requirements, selection criteria, and application details.
8. 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.
Xiao Y, Seagull FJ, Bochicchio GV, et al. Video-based training increases sterile-technique compliance during central venous catheter insertion. Crit Care Med 2007 May;35(5):1302-06. Select to access the abstract in PubMed®.
Raab SS, Stone CH, Wojcik EM, et al. Use of a new method in reaching consensus on the cause of cytologic-histologic correlation discrepancy. Am J Clin Pathol 2006 Dec;126(6):836-42. Select to access the abstract in PubMed®.
Linder JA, Rose AF, Palchuk MB, et al. Decision support for acute problems: the role of the standardized patient in usability testing. J Biomed Inform 2006 Dec;39(6):648-55. Select to access the abstract in PubMed®.
Cowper PA, DeLong ER, Hannan EL, et al. Is early too early? Effect of shorter stays after bypass surgery. Ann Thor Surg 2007 Jan;83(1):100-7. Select to access the abstract in PubMed®.
Ong M, Bostrom A, Vidyarthi A, et al. House staff team workload and organization effects on patient outcomes in an academic general internal medicine inpatient service. Arch Intern Med 2007 Jan 8;167(1):47-52. Select to access the abstract in PubMed®.
If you are a new subscriber or would like to reference information in a previous issue, an archive of this newsletter can be found on AHRQ's Web site at http://www.ahrq.gov/news/enewsix.htm.
Contact Information
Please address comments and questions to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.
Current as of May 2007
Internet Citation:
AHRQ Electronic Newsletter. May 31, 2007, Issue No. 330. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews330.htm
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