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AHRQ Study: Disparity Gaps Narrowing Free Preventive Services Guide Available from
CMS Delmarva/JCAHO Study Analyzes Effectiveness,
Use of Hospital Reporting Websites Analysis Details Impact of New Drug Benefit CMS/AOA Awards Grants to Coordinate Long Term
Care JCAHO Program Aims to Help Patients Recover
at Home WHO Creates Collaborating Center on Patient
Safety An increasing
percentage of African American enrollees in Medicare managed care plans
are being screened for breast cancer or treated for diabetes or heart
disease in accordance with nationally recognized quality measures,
according to a new study. The study, “ Trends in the Quality of
Care and Racial Disparities in Medicare Managed Care,” was supported
by AHRQ, the Health Resources and Services Administration, and Brigham
and Women’s Hospital and was published in the August 18 issue of
the New England Journal of Medicine. The percentages
of African American enrollees with diabetes who had their low-density
lipoprotein (LDL) or “bad cholesterol” levels
measured rose from 61 percent in 1999 to 92 percent in 2003—a 31
percentage point gain. The percentage of African American enrollees with
diabetes who had their LDL levels controlled increased even more—by
46 percentage points (from 23 percent in 1999 to 66 percent in 2003).
White enrollees’ rates also improved for both measures, but the
gains made by African Americans narrowed their gaps with whites from
9 percent to 2 percent for LDL testing and from 13 percent to 7 percent
for LDL control. The percentage of African American and white enrollees prescribed a
beta-blocker drug within 7 days of hospital discharge following a heart
attack, heart bypass surgery, or angioplasty rose, from 64 percent to
93 percent and 76 percent to 94 percent, respectively between 1997 and
2002, narrowing the gap between African Americans and whites with cardiovascular
disease to only 1 percentage point. African
Americans fell further behind whites on only one quality measure – blood
sugar level control. The proportion of African American enrollees with
controlled blood sugar levels rose only 8 percentage points (from 67
percent to 75 percent) compared to an 11 percentage point increase (from
71 percent to 82 percent) for white enrollees. Read an abstract of the study at: http://content.nejm.org/cgi/content/abstract/353/7/692 The Centers
for Medicare & Medicaid Services has announced the availability
of “Guide to Medicare Preventive Services for Physicians, Providers,
Suppliers, and Other Health Care Professionals,” a comprehensive
guide to Medicare-covered preventive services and screenings. The publication
is intended to give physicians, providers, suppliers, and other health
care professionals that bill Medicare fee-for-service contractors information
on coverage, coding, billing, and reimbursement to help them file claims
effectively, while also giving providers information that will enable
them to encourage utilization of these benefits as appropriate. The guide
is available in a downloadable PDF version at http://www.cms.hhs.gov/medlearn/preventiveservices.asp.
It can also be ordered, free of charge, through the Medicare Learning
Network's Medlearn home page at: www.cms.hhs.gov/medlearn. An increasing number of consumers utilize online hospital performance
websites to make health care decisions, while providers use the measures
highlighted in those online resources to make quality improvement decisions,
according to a new study. The analysis of the effectiveness and constitution
of more than 50 publicly available and subscription based online hospital
performance websites was a joint effort between Delmarva Foundation,
the QIO for Maryland and the District of Columbia, and the Joint Commission
on Accreditation of Healthcare Organizations (JCAHO). Prepared as a part of the Centers for Medicare and Medicaid Services
(CMS) Hospital Three State Pilot project, the study found that 20 states
have at least one hospital performance website sponsored by non-profit
organizations or government agencies containing tables, evaluative symbols,
and bar graphs to demonstrate comparisons of providers in geographically
connected regions. In their analysis, the researchers also found that most sites offered
lists of frequently asked questions and a consumer checklist. Almost
71 percent of the sites suggest that users speak with their doctors about
hospital performance. The study also detected what measures consumers would like to see reported
in online resources in the future. Those include information about patient
satisfaction with treatment and the rates of surgical infections after
surgery. Publicly
reported hospital data are currently available through CMS’ Hospital
Compare website, www.HospitalCompare.hhs.gov,
and the Joint Commission’s Quality Check website, www.qualitycheck.org. To access
a copy of the study, visit Delmarva’s website at www.delmarvafoundation.org. A state-by-state
analysis, “Medicare Tomorrow: Future Savings
for Beneficiaries,” released by Medicare Today shows the impact
of the new Medicare drug benefit on beneficiaries. Analysts used federal health data to compile state-by-state snapshots
and national aggregate data of the impact the new Medicare drug benefit
will have on seniors. The findings: Medicare
Today is a national partnership of more than 200 organizations such
as AARP, the American Academy of Family Physicians, and the National
Association of Chain Drug Stores, committed to providing consumers
with objective, easy-to-understand information about Medicare’s
new prescription drug coverage. Read the full report at: The Centers
for Medicare & Medicaid
Services (CMS) and the Administration on Aging (AOA) has announced
$15 million in grants to 19 states to create a single source of information
and assistance for families navigating the often confusing array of
long-term care services available in their communities. The Aging
and Disability Resource Center (ADRC) grants, jointly administered
by CMS and AOA, are part of the New Freedom Initiative, an administration
effort to help overcome barriers to community living for the elderly
and disabled. Currently, a broad range of programs and services
sponsored by numerous agencies are available to assist older adults and
individuals with disabilities. Those seeking these services often
have difficultly sorting through or even locating community-based services,
a barrier that may result in unnecessary and costly institutionalization. The ADRC grants are designed to address this by allowing states to coordinate
all available services into one system while allowing flexibility in
the development and administration of programs. States and
territories receiving the grants are: Alabama, Arizona, Colorado, District
of Columbia, Guam, Hawaii, Idaho, Kansas, Kentucky, Michigan, Mississippi,
Nevada, Ohio, Tennessee, Texas, Vermont, Virginia, Washington and Wyoming. All
together, 43 states have received the three-year grants with awards
of up to $800,000. For more information, visit: http://www.aoa.gov, www.cms.hhs.gov/newfreedom/default.asp,
or www.adrc-tae.org. The Joint
Commission on Accreditation of Healthcare Organizations (JCAHO) recently
launched a new initiative to help patients continue their recovery
after leaving the hospital. The new patient education effort is the
latest focus of JACHO’s Speak Up program, which urges individuals
to take an active role in their health care. Patients
who understand and follow directions about follow-up care are more
likely to heal faster and less likely to require re-hospitalization. That
is why the centerpiece of this effort is a new brochure, “Planning
Your Recovery,” which provides tips to help people get the information
they need and become actively involved in their recovery. The
brochure urges patients to: find out about their condition, about new
medicines, and about needed follow-up care. The brochure is available
in English and Spanish online at: http://www.jcaho.org/accredited+organizations/speak+up/recovery.htm The World
Health Organization (WHO) has designated the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO) and Joint Commission International
(JCI) as the world’s first WHO Collaborating Center
dedicated solely to patient safety. The Collaborating Center on Patient
Safety Solutions is tasked with reducing the high numbers of serious
medical injuries around the world that occur each day. The collaboration will focus worldwide attention on patient safety and
best practices that can reduce risks to patients, and coordinate international
efforts to spread these solutions as broadly as possible. This will be
accomplished by collaborating internationally with ministries of health,
patient safety experts, national agencies on patient safety, health care
professional associations, and consumer organizations. For more
information, visit: http://www.who.int/patientsafety/newsalert/issue2/en/ In a nationwide
study of nearly 700 large medical groups, UC Berkeley researchers found
that only about 11% of the medical groups scored in the top quartile
on at least four out of six overall performance measures. The findings
of “An Empirical Assessment of High Performing Medical
Groups,” were p ublished in the August issue of the journal Medical
Care Research and Review . According to the study, high
performing groups: averaged 20 out of a possible 30 points on overall
quality measures compared with 2.9 for the low performing groups; averaged
10.6 out of 16 possible points for the use of disease registries, clinical
guidelines, care management systems, feedback to physicians and patient
self-management programs versus 1.0 for low performing groups; averaged
9.8 out of 13 possible points for the use of health promotion and disease
prevention services compared with only 1.1 for the low performing groups. “Groups
that encouraged formal involvement in quality improvement, such as implementing
a systematic method of measuring patient satisfaction and a requirement
to report quality results to outside bodies were more likely to rank
in the top 25 percent of almost all performance measures,” said
the researchers. An abstract of the study is available at: http://mcr.sagepub.com/cgi/content/abstract/62/4/407 A study by Mayo Clinic researchers published in the August 30 edition
of Circulation provides further evidence of
aspirin’s benefits for patients with heart disease and suggests
patients should continue taking it even in the days leading up to surgery.
In “Preoperative Aspirin Therapy Is Associated With Improved Postoperative
Outcomes in Patients Undergoing Coronary Artery Bypass Grafting,” investigators
divided more than 1600 patients into two groups (those with preoperative
aspirin and those without) and found that in-hospital mortality for the
aspirin group (1.7 percent) was significantly less than that for those
not receiving aspirin (4.4 percent) with no increased risk of re-operation
for excessive internal bleeding. Read an abstract of the study at: http://circ.ahajournals.org/cgi/content/abstract/112/9_suppl/I-286 In the September 1 issue of the American Journal of Cardiology,
the study “ Effect of Statin Use Within the First 24 Hours of Admission
for Acute Myocardial Infarction on Early Morbidity and Mortality,” indicates
that treatment with a statin drug within 24 hours of having a heart attack
reduced in-hospital mortality rates by more than 50 percent. Using data
from more than 170,000 patients in the National Registry of Mycocardial
Infarction 4 for the largest clinical study of its kind, the researchers
found that in addition to increasing survival, early statin use was associated
with a lower incidence of cardiac arrest, cardiac shock, cardiac rupture,
and ventricular fibrillation after a heart attack. The full study is
available free at: http://www.ajconline.org/article/PIIS0002914905009252/fulltext In the August issue of Critical Care Medicine,
the study “The Critical Care Safety Study: The incidence and nature
of adverse events and serious medical errors in intensive care” reveals
that “adverse events and serious errors involving critically ill
patients were common and often potentially life-threatening.” Researchers
conducted a one-year observational study of patients in the ICU and coronary
care units of a large teaching hospital. They found: 120 adverse events
in 79 patients (20%), nearly half of which were preventable, and 13%
were life-threatening or fatal; 223 serious errors, 11% were potentially
life-threatening; the majority of serious errors (61%) occurred during
the ordering or execution of treatment, most associated with medication.
The study abstract is available at: http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200508000-00003.htm;jsessionid=DWr1syhb2YO23ZJUV7hBZluLocwInr6AZmFwD37xY101U04rSXA5!1389088241!-949856145!9001!-1 At the 230th national meeting of the American Chemical Society on
Monday, Notre Dame researchers presented their work on a new antibiotic
that effectively fights vancomycin-resistant MRSA. The new antibiotic
is a synthetic form of cephalosporin and appears to kill bacteria (staph
and other strains) by masquerading as components of the bacterial cell
wall in order to deactivate an enzyme that functions as a key bacterial
defense mechanism. For more information, contact the American Chemical
Society press office at: 202-872-6228.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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