ahrq

PSOs picked for implementation of safety legislation

Dan Bowman — Wed, 05 Nov 2008 10:54:41 -0500

Ten organizations were designated as "patient-safety organizations" by the Agency for Healthcare Research and Quality, in an attempt to oversee how PSOs will collect and share patient safety data. Each of the 10 organizations will work with providers to gather information about medical errors and report them as necessary. Currently, the organizations are awaiting rulings that will enable them to collect their data in a correct manner.

Once given the "OK," the federal government's Patient Safety and Quality Improvement Act (of 2005) will go into effect. Through this act, a "network of PSOs" will be used to ensure the safety of patients while implementing improvements.

For more information:
- read this Modern Healthcare article
- check out the list of organizations

GAO: HHS agencies need to collaborate to fight HAIs

Thu, 17 Apr 2008 06:59:57 -0400

If they're to make any real progress in fighting hospital-associated infections, HHS agencies will need to work together more closely, according to the Government Accountability Office. GAO director for healthcare issues Cynthia Bascetta told Congress that while the various agencies with a stake in fighting HAIs--including CMS, the CDC and the AHRQ--"have a sense of urgency" about the problem, they're not working together closely. At present, they're largely limiting their collaboration to updating each other on their independent databases, she told the House Committee on Oversight and Government Reform. According to a report the GAO released at the committee hearing, the agencies would do better if they created links across these databases--something that would allow all of the agencies involved to better understand where and how hospital infections are acquired.

To learn more about GAO's recommendations:
- read this Modern Healthcare piece (reg. req.)
- read the GAO report (.pdf)

Related Articles:
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Report assesses the economic impact of hospital-acquired infections
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Study: Ethnic bias not seen in care for same condition

Thu, 13 Mar 2008 07:59:54 -0400

As we've detailed here in the past, disparities in care between whites and ethnic minorities continue to exist throughout the U.S. However, there's at least one area where whites and minorities seem to fare equally in quality of care--though oddly enough, outcomes seem to be worse--according to a new study appearing in the March/April edition of the journal Health Affairs. It appears that when they're being treated in a hospital for the same condition, or getting the same procedure, care for whites and minorities is about equal.

The study drew on state patient discharge data from 13 states from 2000 to 2003, plus data from Pennsylvania and Texas public health authorities and the AHRQ's Healthcare Cost and Utilization project. When researchers crunched the numbers, they found that there were indeed racial disparities in the overall rates of mortality and adverse events for patients, but no major differences in the quality of care between whites and minorities.

To get more data from the study:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Study: Hispanics get lower-quality medical care. Report
CMS hopes to close Medicare race, ethnicity gap. Report
Study: 'Medical homes' cut racial care disparities. Report
Racial disparities persist in health outcomes. Report

Report: Inpatient death rates falling

Thu, 11 Oct 2007 06:59:56 -0400

It looks like hospitals have made some real progress in treating common potentially fatal conditions over the past 10 years. According to a new report from the Agency for Healthcare Research and Quality, death rates for patients with from heart attack, congestive heart failure, stroke, pneumonia, gastrointestinal hemorrhage or hip fracture fell noticeably from 1994 to 2004. This includes a 43 per 1,000 admissions drop in deaths from heart attack, 30 per 1,000 drop in deaths from congestive heart failure, pneumonia and stroke, and 21 per 1,000 for gastrointestinal hemorrhage. These findings are adjusted for patient acuity over time.

To learn more about this report:
- read this Modern Healthcare article

Related Articles:
AHRQ: Access could cut 4.4 million hospitalizations a year. Report
Pneumonia vaccine cuts child hospitalizations. Report
Better nursing home care cuts hospitalizations. Report
Study: Higher co-pays cut hospital visits. Report

Access could cut 4.4M hospitalizations a year

Mon, 13 Aug 2007 06:59:55 -0400

If Americans had better primary care, better access to treatment and made some important lifestyle changes, about 4.4 million hospitalizations per year could be avoided, according to a new report issued by the Agency for Healthcare Research and Quality. The report said that these savings would represent 10 percent of all hospital costs for 2004.

With care access and improved lifestyles, the U.S. could have saved $8.3 billion in preventable hospitalizations for congestive heart failure, $7 billion for bacterial pneumonia, $3.4 billion for COPD and $2.6 billion on diabetes complications. It also found that $509 million could have been saved with better treatment for high blood pressure.

To learn more about the research:
- read this Modern Healthcare piece
- read the AHRQ report (.pdf)

Related Articles:
Pneumonia vaccine cuts child hospitalizations. Report
Better nursing home care cuts hospitalizations. Report
Study: Higher co-pays cut hospital visits. Report

Study:Primary care costs, reimbursement low

Wed, 25 Apr 2007 20:01:37 -0400

Primary care costs much less than specialty care, but insurers aren't necessarily taking that into account, according to a new study. The study, by HHS's Agency for Healthcare Research and Quality, noted that while orthopedist fees averaged $210 per visit, and cardiologists $232 per visit, primary care physicians typically charge $100 per visit. But insurers still penalize primary care, requiring patients to pay an average of 20 percent of PCP costs out-of-pocket. Despite higher costs, specialty co-pays were lower, the AHRQ found. For example, insurers only required consumers to pay 16 percent of orthopedist fees and 13 percent of cardiologist fees. These results are a bit of a surprise, given that health plans have every reason to encourage prevention-oriented primary care treatment. Sounds like it's time for some benefits tweaking.

To find out more about the study:
- read this United Press International article

Related Articles:
Study: Lower pay threatens PCP supply. Report
Study examines primary care doc satisfaction. Report
Program offers improved training for PCPs. Report
GAO: 10% of PCPs provide extra services. Report

Lawmakers want study of doc hours, error rates

Wed, 11 Apr 2007 20:01:36 -0400

A group of ranking U.S. House Energy and Commerce Committee members are asking HHS for a new study of the relationship between physician schedules and medical errors. The group, which has been conducting ongoing research into preventable medical errors, includes committee chairman John Dingell (D-MI), ranking member Joe Barton (R-TX), and Reps. Bart Stupak (D-MI.) and Ed Whitfield (R-KY). The legislators are asking the HHS Agency for Healthcare Research and Quality to fund an Institute of Medicine study shedding more light on the connection between physicians' work schedules and their propensity for making medical mistakes. The new research would follow up on a 2006 study by AHRQ which found that interns who worked longer hours made more mistakes.

To learn more about the proposal:
- read this United Press International item
- read the lawmakers' letter to AHRQ (.pdf)
- see Rep. Dingell's press release

ALSO: Rep. Dingell has just introduced a new bill which would improve dental coverage for low-income children relying on Medicaid and SCHIP for care. Release

Related Article:
Providers get safety advice from pilots. Report

Agency advocates for quality data standards

Sun, 01 Apr 2007 20:01:35 -0400

Right now, either hospital medical records departments or medical group practice administrators typically end up collecting quality data, a costly and time-consuming exercise which only gets more taxing from year to year as health plans, state and federal regulators demand more. According to a new study by the Agency for Healthcare Research and Quality (AHRQ), the right information technology could ease the strain, but only if all of the stakeholders agree on common data standards. In the mean time, as standards evolve, the industry can take several steps to make quality data reporting simpler, the AHRQ said. For one thing, it will help if EMR vendors to have a clear idea of what types of quality data providers need, and organize their products accordingly, the report noted. AHRQ would also like to see key industry players develop a standard set of data points which can be gathered at the point of care rather than extracted from records.

To get more recommendations from the report:
- read this Modern Healthcare item (sub. req.)
- read the AHRQ report (.pdf)

Related Articles:
EHRs boost quality, raise costs at community clinics. Report
Bill creates physician quality reporting system. Report
Study: Healthcare quality movement stalled. Report
HHS plans quality info exchanges. Report

Disease management program makes headway

Wed, 28 Feb 2007 19:01:35 -0500

According to a new study, efforts to improve the quality of care for diabetes, asthma and hypertension have improved processes of care for these conditions. However, this was not found to improve intermediate clinical outcomes. The study was designed to improve healthcare for urban and rural low-income patients receiving care in community health centers.

As a result of the effort, there was a 21 percent increase in foot examinations for patients with diabetes, a 14 percent increase in the use of anti-inflammatory medication for patients with asthma, and a 16 percent increase in the level of screening for glycated hemoglobin in patients with diabetes mellitus. Though these are positive trends, the lack of corresponding impact on outcomes demonstrates how difficult it is for such studies to have an impact on patient outcomes. "There is still much to learn about the tools and methods for quality improvement and their potential effectiveness. The substantial room for improvement in the post intervention period suggests the need for continued refinement of these quality improvement methods," noted Bruce E. Landon, M.D., M.B.A., who directed the program. The study was conducted by the AHRQ and Health Resources and Services Administration.

For more:
- read the press release on the findings

Press Release: Cardiovascular Drugs, Four Other Therapeutic Classes of Drugs Dominate the Market

Maureen Martino — Fri, 26 Jan 2007 09:07:27 -0500

Cardiovascular Drugs, Four Other Therapeutic Classes of Drugs Dominate the Market

ROCKVILLE, Md., Jan. 24, 2007 -- In 2004, American adults spent $32 billion on cardiovascular drugs, putting them at the top of the five costliest classes of drugs prescribed by doctors for people age 18 and over, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The five costliest classes of drugs combined accounted for two thirds – $119 billion – of the $181 billion total expenditures spent on outpatient prescription medications by adults in the United States in 2004.

Hormones were the second-costliest drug class ($25 billion), followed by central nervous system drugs ($24 billion), which can be used to treat pain and control seizures; cholesterol-lowering medications ($22 billion); and anti-depressants and other psychotherapeutic drugs ($18 billion).
Among adults who had a prescription drug purchase in 2004, the highest percentage purchased at least one central nervous system drug (44 percent), followed by cardiovascular medications (38 percent), hormones (37 percent), anti-cholesterol drugs (22 percent), and antidepressants (20 percent).
AHRQ also looked at spending for the top five therapeutic classes of drugs prescribed for Medicare beneficiaries age 65 and older in 2004.

The top five classes were cardiovascular drugs ($17 billion), cholesterol-lowering drugs ($10 billion), hormones ($8 billion), central nervous system drugs ($7 billion), and gastrointestinal drugs ($6 billion). Spending totaled nearly $48 billion.
Expenditures for these drugs accounted for roughly three-quarters of the $65 billion spent on all prescription drugs for Medicare beneficiaries age 65 and older in 2004.
AHRQ, a part of the U.S. Department of Health and Human Services, works to improve the quality, safety, efficiency and effectiveness of health care in the United States. The data in this AHRQ News and Numbers comes from the Agency’s Medical Expenditure Panel Survey, a highly detailed source of information on the health services that Americans use, how frequently they use them, the cost of these services, and how they are paid.

For more information on this AHRQ News and Numbers please see the attachment.

For more information or to speak with an AHRQ data expert, contact Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.