Agency for Healthcare Resea And Quality's Books

Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide

By: Agency for Health Care Research and Quality (U.S.)

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Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide

By: Agency for Health Care Research and Quality (U.S.)

This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

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236

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Government Printing Office

Published Date

ISBN 10

1587634236

ISBN 13

9781587634239

Registries for Evaluating Patient Outcomes

A User’s Guide

By: Agency for Healthcare Research and Quality/AHRQ

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Registries for Evaluating Patient Outcomes

A User’s Guide

By: Agency for Healthcare Research and Quality/AHRQ

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

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385

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Government Printing Office

Published Date

ISBN 10

1587634333

ISBN 13

9781587634338

Registries for Evaluating Patient Outcomes

A User’s Guide

By: U.S. Agency for Health Care Research and Quality/AHRQ

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Registries for Evaluating Patient Outcomes

A User’s Guide

By: U.S. Agency for Health Care Research and Quality/AHRQ

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349

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Government Printing Office

Published Date

ISBN 10

1587634341

ISBN 13

9781587634345

Strategies to Leverage Research Funding

Guiding DOD's Peer Reviewed Medical Research Programs

By: Institute of Medicine,Board on Health Sciences Policy,Medical Follow-Up Agency,Committee on Alternative Funding Strategies for DOD's Peer Reviewed Medical Research Programs

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Strategies to Leverage Research Funding

Guiding DOD's Peer Reviewed Medical Research Programs

By: Institute of Medicine,Board on Health Sciences Policy,Medical Follow-Up Agency,Committee on Alternative Funding Strategies for DOD's Peer Reviewed Medical Research Programs

Since 1992 the Department of Defense (DOD), through the U.S. Army Medical Research and Material Command, has received congressionally earmarked appropriations for programs of biomedical research on prostate, breast, and ovarian cancer; neurofibromatosis; tuberous sclerosis; and other health problems. Appropriations for these Congressionally Directed Medical Research Programs are used to support peer reviewed extramural research project, training, and infrastructure grants. Congress has become concerned about funding increases for these programs given current demands on the military budget. At the request of Congress, the Institute of Medicine (IOM) examined possibilities of augmenting program funding from alternative sources. The resulting IOM book, Strategies to Leverage Research Funding: Guiding DOD's Peer Reviewed Medical Research Programs, focuses on nonfederal and private sector contributions that could extend the appropriated funds without biasing the peer review project selection process.

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193

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National Academies Press

Published Date

ISBN 10

0309092779

ISBN 13

9780309092777

Giving Full Measure to Countermeasures

Addressing Problems in the DoD Program to Develop Medical Countermeasures Against Biological Warfare Agents

By: National Research Council,Institute of Medicine,Board on Life Sciences,Medical Follow-up Agency,Committee on Accelerating the Research, Development, and Acquisition of Medical Countermeasures Against Biological Warfare Agents

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Giving Full Measure to Countermeasures

Addressing Problems in the DoD Program to Develop Medical Countermeasures Against Biological Warfare Agents

In recent years, substantial efforts have been initiated to develop new drugs, vaccines, and other medical interventions against biological agents that could be used in bioterrorist attacks against civilian populations. According to a new congressionally mandated report from the Institute of Medicine and National Research Council of the National Academies, to successfully develop these drugs, vaccines, and other medical interventions against biowarfare agents, Congress should authorize the creation of a new agency within the Office of the Secretary of the U.S. Department of Defense. The committee recommended that Congress should improve liability protections for those who develop and manufacture these products, to stimulate willingness to invest in new research and development for biowarfare protection. Giving Full Measure to Countermeasures also identifies other challengesâ€"such as the need for appropriate animal models and laboratories equipped with high-level biosafety protectionsâ€"that will require attention if DoD efforts to develop new medical countermeasures are to be successful.

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160

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National Academies Press

Published Date

ISBN 10

0309166519

ISBN 13

9780309166515

Improving the Social Security Disability Decision Process

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Improving the Disability Decision Process: SSA's Listing of Impairments and Agency Access to Medical Expertise

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Improving the Social Security Disability Decision Process

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Improving the Disability Decision Process: SSA's Listing of Impairments and Agency Access to Medical Expertise

The Social Security Administration (SSA) provides Social Security Disability Insurance (SSDI) benefits to disabled persons of less than full retirement age and to their dependents. SSA also provides Supplemental Security Income (SSI) payments to disabled persons who are under age 65. For both programs, disability is defined as a "medically determinable physical or mental impairment" that prevents an individual from engaging in any substantial gainful activity and is expected to last at least 12 months or result in death. Assuming that an applicant meets the nonmedical requirements for eligibility (e.g., quarters of covered employment for SSDI; income and asset limits for SSI), the file is sent to the Disability Determination Services (DDS) agency operated by the state in which he or she lives for a determination of medical eligibility. SSA reimburses the states for the full costs of the DDSs. The DDSs apply a sequential decision process specified by SSA to make an initial decision whether a claim should be allowed or denied. If the claim is denied, the decision can be appealed through several levels of administrative and judicial review. On average, the DDSs allow 37 percent of the claims they adjudicate through the five-step process. A third of those denied decide to appeal, and three-quarters of the appeals result in allowances. Nearly 30 percent of the allowances made each year are made during the appeals process after an initial denial. In 2003, the Commissioner of Social Security announced her intent to develop a "new approach" to disability determination. In late 2004, SSA asked the Institute of Medicine (IOM) to help in two areas related to its initiatives to improve the disability decision process: 1) Improvements in the criteria for determining the severity of impairments, and 2) Improvements in the use of medical expertise in the disability decision process. This interim report provides preliminary recommendations addressing the three tasks that relate to medical expertise issues, with a special focus on the appropriate qualifications of medical and psychological experts involved in disability decision making. After further information gathering and analyses of the effectiveness of the disability decision process in identifying those who qualify for benefits and those who do not, the committee may refine its recommendations concerning medical and psychological expertise in the final report. The final report will address a number of issues with potential implications for the qualifications of the medical experts involved in the disability decision process.

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290

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National Academies Press

Published Date

ISBN 10

0309103819

ISBN 13

9780309103817

Protecting Our Forces

Improving Vaccine Acquisition and Availability in the U.S. Military

By: Institute of Medicine,Medical Follow-up Agency,Committee on a Strategy for Minimizing the Impact of Naturally Occurring Infectious Diseases of Military Importance: Vaccine Issues in the U.S. Military

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Protecting Our Forces

Improving Vaccine Acquisition and Availability in the U.S. Military

Infectious diseases continue to pose a substantial threat to the operational capacity of military forces. Protecting Our Forces reviews the process by which the U.S. military acquires vaccines to protect its warfighters from natural infectious disease threats. The committee found that poorly aligned acquisition processes and an inadequate commitment of financial resources within the Department of Defense vaccine acquisition process â€" rather than uncleared scientific or technological hurdles â€" contribute to the unavailability of some vaccines that could protect military personnel and, implicitly, the welfare and security of the nation. Protecting Our Forces outlines ways in which DoD might strengthen its acquisition process and improve vaccine availability. Recommendations, which include combining all DoD vaccine acquisition responsibilities under a single DoD authority, cover four broad aspects of the acquisition process: (1) organization, authority, and responsibility; (2) program and budget; (3)manufacturing; (4) and the regulatory status of special-use vaccines.

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159

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National Academies Press

Published Date

ISBN 10

0309084997

ISBN 13

9780309084994

An Assessment of the CDC Anthrax Vaccine Safety and Efficacy Research Program

By: Committee to Review the CDC Anthrax Vaccine Safety and Efficacy Research Program,Medical Follow-Up Agency,Institute of Medicine

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An Assessment of the CDC Anthrax Vaccine Safety and Efficacy Research Program

By: Committee to Review the CDC Anthrax Vaccine Safety and Efficacy Research Program,Medical Follow-Up Agency,Institute of Medicine

In 1998, the Department of Defense (DoD) began a program of mandatory immunization against anthrax for all military personnel. As the program proceeded, however, some military personnel and their families raised concerns about the safety and efficacy of the anthrax vaccine. Acknowledging both the need to protect military personnel and the concerns about the anthrax vaccine, congress directed the Centers for Disease Control and Prevention (CDC) to carry out a research program on its safety and efficacy. To assist in the development of this program, CDC requested the Institute of Medicine (IOM) to convene a committee to review the completeness and appropriateness of the research program. In An Assessment of the CDC Anthrax Vaccine Safety and Efficacy Research Program, the committee makes an overall assessment of the CDD research plan and reviews the specific studies proposed by CDC in the three areas of efficacy, safety and acceptability. The committee also notes additional research needs that became evident following the bioterrorist events of 2001 and makes recommendations about the leadership of the research program.

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179

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National Academies Press

Published Date

ISBN 10

0309168953

ISBN 13

9780309168953

Ahrq Annual Highlights, 2005

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2005

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

The U.S. health care system is considered by many to be the finest in the world. Americans are living longer, healthier lives, thanks to significant advances in biomedical and health services research. The translation of research findings into clinical practice has raised awareness of the importance of appropriate preventive services—such as timely screenings for cancer, heart disease, and other serious conditions—and the crucial role that sustaining a healthy lifestyle plays in maintaining health and enhancing quality of life. However, our health care system faces many challenges, including improving the quality and safety of health care, ensuring access to care, increasing value for health care, reducing disparities, increasing the use of health information technology, and finding new avenues to translate research into practice. We have made progress in meeting these challenges, but we can and must do better. The Agency for Healthcare Research and Quality (AHRQ)—one of the 12 agencies within the Department of Health and Human Services—plays an important role in responding to the challenges faced by our health care system. The Agency's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans and support efforts to translate research into practice. One of the ways we fulfill this mission is to conduct and support health services research that: Reduces the risk of harm from health care services by using evidence-based research and technology to promote the delivery of the best possible care; Transforms research into practice to achieve wider access of effective health care services and reduce unnecessary health care costs; Improves health care outcomes by encouraging providers, consumers, and patients to use evidence-based information to make informed treatment choices/decisions. The Agency's research agenda is user-driven—that is, AHRQ actively responds to the needs of its customers and we work with the users of our research to help them make measurable differences in the health care system. In 2005, AHRQ's research agenda reflected a shift in the scope and nature of health services research to emphasize the translation of research into practice. Our goal is to make an impact on health care and the health care system. Providers, purchasers, policymakers, researchers, and the public all need evidence-based information that not only identifies problems with patient safety, quality, and disparities in health care, but also offers solutions. This report presents key findings from AHRQ's 2005 research portfolio. It highlights the advances made and our progress in moving from research to practice.

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ISBN 10

1499327587

ISBN 13

9781499327588

Ahrq Annual Report on Research and Financial Management, Fy 2004

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Report on Research and Financial Management, Fy 2004

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality's (AHRQ) FY 2004 Annual Report highlights the research and financial management activities and accomplishments of the Agency and its employees. This report highlights the Agency's programmatic and financial accomplishments. The Agency for Healthcare Research and Quality (AHRQ)—one of 12 agencies of the Department of Health and Human Services—has a leadership role in finding answers to difficult questions that challenge the Nation's health care system. AHRQ's focus is on getting research results into the hands of those who can put it to practical use as rapidly as possible. This report demonstrates our resolve to improve the quality and delivery of health care services provided in this Nation, as well as our continued commitment to assure sound investments in programs that will make a difference. AHRQ's research is based on the needs of users—patients, clinicians, health system leaders, and policymakers. The Agency's research provides the scientific foundation for the country's efforts to improve the quality, safety, effectiveness, and efficiency of health care. AHRQ supports the work of health services researchers at the Nation's leading academic centers through extramural grants and contracts, and maintains a rigorous intramural research program that collects and analyzes data to understand changes in health care quality, cost, use, and access. The Agency also supports efforts to develop the tools, knowledge, and information used by the public and private sectors to measure and improve health care quality. AHRQ recognizes that reducing medical errors and improving patient safety is critically important for enhancing the quality of health care. Developing the nation's health information technology infrastructure is integral to delivering safe, high quality health care services. Therefore, in concert with the Department's 10-year plan to transform health care delivery through the use of health information technology, the Agency began a series of projects aimed at increasing the adoption of information technology and speeding the transformation of health care services in America. These projects will provide insight into how best to use health information technologies to improve patient safety by reducing medication errors; bridging the communication gap between primary care physicians, specialists, and patients; and reducing duplicative and unnecessary testing. The growth in information technology and the demand for the best possible evidence to guide health care decisions will result in improved delivery of health care. Every day it becomes more apparent that AHRQ's research is making a difference, as more patients, clinicians, health system leaders, and policymakers seek evidence to inform their health care decisions. Long-standing programs continue to inform health care decisions made at all levels of the health care system, while newer programs are producing findings that promise to have a significant impact on the health care system.

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156

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ISBN 10

1499383509

ISBN 13

9781499383508

National Healthcare Quality Report, 2007

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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National Healthcare Quality Report, 2007

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

Since 2003, the Agency for Healthcare Research and Quality (AHRQ), together with its partners in the Department of Health and Human Services (HHS), has reported on progress and opportunities for improving health care quality. With this fifth annual National Healthcare Quality Report (NHQR), these reports will have provided more than 50,000 data points about health care quality in the United States. Has it made a difference? Have Federal and State governmental agencies, provider organizations, insurers, and employers made progress in improving health care quality and safety? While every previous release of the NHQR has attempted to summarize the direction in which health care quality is going, this fifth report tries to summarize the progress that has been made and the remaining challenges to improve health care quality in this Nation. The NHQR is built on 218 measures categorized across four dimensions of quality—effectiveness, patient safety, timeliness, and patient centeredness. This year's report focuses on the state of health care quality for a group of 41 core report measures that represent the most important and scientifically credible measures of quality for the Nation, as selected by the HHS Interagency Work Group. The distillation of 41 core measures for the 2007 report provides a more readily understandable summary and explanation of the key results derived from the data. While the measures selected for inclusion in the NHQR are derived from the most current scientific knowledge, this knowledge base is not evenly distributed across health care. The analysis in the following pages centers on measures for which data are available from the baseline year of 2000 or 2001 and the comparison year of 2004 or 2005. Three themes that emerge from the 2007 NHQR emphasize the need to accelerate progress in achieving high quality health care: Health care quality continues to improve, but the rate of improvement has slowed; Variation in quality of health care across the Nation is decreasing, but not for all measures; The safety of health care has improved since 2000, but more needs to be done.

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142

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ISBN 10

1499340362

ISBN 13

9781499340365

Ahrq Annual Highlights, 2010

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2010

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

In fiscal year 2010 (FY10), the Agency for Healthcare Research and Quality (AHRQ) was able to increase key investments to help improve the safety and quality of health care, ensure access to care, increase the value of health care, reduce disparities, and increase the use of health information technology. In addition, the Patient Protection and Affordable Care Act (Affordable Care Act), signed by the President into law on March 23, 2010, brought new and exciting opportunities to improve the quality, safety, efficiency, and effectiveness of health care services. As 1 of 12 agencies within HHS, the mission of AHRQ is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The Agency fulfills this mission by working with information that: Reduces the risk of harm from health care services by using evidence-based research and technology to promote the delivery of the best possible care; Transforms the practice of health care to achieve wider access to effective services and reduce unnecessary health care costs; Improves health care outcomes by encouraging providers, consumers, and patients to use evidence-based information to make informed treatment decisions. Ultimately, the Agency achieves its goals by translating research into improved health care practice and policy. Health care providers, patients, policymakers, payers, administrators, and others use AHRQ research findings to improve health care quality, accessibility, and outcomes of care. Disseminating AHRQ's research findings helps support a Nation of healthier, more productive people and results in an enhanced return on the Nation's substantial investment in health care. This report presents key accomplishments, initiatives, and research findings from AHRQ's research Portfolios during FY10. The Agency's mission helps HHS achieve its strategic goals to transform health care, implement the Recovery Act, promote early childhood health and development, help Americans achieve and maintain healthy weight, prevent and reduce tobacco use, protect the health and safety of Americans in public health emergencies, accelerate the process of scientific discovery to improve patient care, and ensure program integrity and responsible stewardship. The Agency has a broad research portfolio that touches on nearly every aspect of health care including: Clinical practice; Outcomes and effectiveness of care; Evidence-based practice; Primary care and care for priority populations; Health care quality; Patient safety/medical errors; Organization and delivery of care and use of health care resources; Health care costs and financing; Health information technology; Knowledge transfer.

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ISBN 10

1499327951

ISBN 13

9781499327953

Ahrq Annual Report on Research and Financial Management, Fy 2001

By: Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Report on Research and Financial Management, Fy 2001

By: Department of Health and Human Services,Agency for Healthcare Research and Quality

In the first decade of the 21st century, the Nation faces critical challenges in health care. A combination of unprecedented advances in health care treatments and rapidly increasing health care costs requires the use of scientific evidence to assure that those most likely to benefit receive effective services and that the return on our investment in health care results in improved health. Research on these and other pressing issues is at the center of the mission of the Agency for Healthcare Research and Quality. Our goal at AHRQ is to support and conduct research that addresses and anticipates health care challenges facing policymakers, health system leaders, clinicians, patients, and families. These challenges include quality of care, patient safety, access to effective care, and the costs of care. The first section of this report presents information on the programs and activities undertaken by AHRQ in FY 2001 and provides examples of some recent accomplishments. The second section of the report presents financial statements and detailed information about AHRQ's resources and expenditures. To set the stage for this discussion, this report presents information about the state of health care in America today and describes the role AHRQ can play in addressing some of the most important challenges and questions facing the Nation's health care system in these first few years of a new century. The report also presents AHRQ's organizational structure and key responsibilities of functional components, describes the Agency's National Advisory Council, and identifies the various audiences and customers who use the findings from Agency supported research.

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116

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Published Date

ISBN 10

1499383142

ISBN 13

9781499383140

Ahrq Annual Highlights, 2012

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2012

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

The Agency for Health Care Research and Quality (AHRQ) is 1 of 12 agencies within the Department of Health and Human Services (HHS). Its mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The Agency fulfills this mission by conducting health care services research which examines how people get access to health care, how much care costs, and what happens as a result of the care they receive. The principal goals of health services research are to identify the most effective ways to organize manage, finance, and deliver high quality care, reduce medical errors, and improve patient safety. AHRQ pursues its mission through six research portfolios: Patient-Centered Health Research: improves health care quality by providing patients and physicians with state-of-the-science information on which medical treatments work best for a given condition; Prevention/Care Management Research: focuses on improving the quality, safety, efficiency, and effectiveness of the delivery of evidence-based preventive services and chronic care management in ambulatory care settings; Value Research: focuses on finding a way to achieve greater value in health care – reducing unnecessary costs and waste while maintaining or improving quality; Health Information Technology: Health IT research develops and disseminates evidence and evidence-based tools to inform policy and practice on how Health IT can improve the quality of American health care; Patient Safety: identifies risks and hazards that lead to medical errors and finding ways to prevent patient injury associated with delivery of health care; Crosscutting Activities Related to Quality, Effectiveness and Efficiency: includes investigator-initiated and targeted research grants and contracts that focus on health services research in the areas of quality, effectiveness, and efficiency. Crosscutting Activities also includes additional research activities that support all of our research portfolios including data collection, measurement, dissemination and translation, and program evaluation. In addition to AHRQ's six research portfolios, the Agency supports the Medical Expenditure Panel Survey (MEPS), which is the only national source for annual data on how Americans use and pay for medical care. MEPS supports all of AHRQ's research related strategic goal areas. AHRQ's vision is that, as a result of its efforts, American health care will provide services of the highest quality, with the best possible outcomes, at the lowest cost. This report represents the Agency's key accomplishments, initiatives, and research findings during fiscal year 2012 (FY12) that have brought us closer to making this vision a reality.

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ISBN 10

1499328060

ISBN 13

9781499328066

Ahrq Annual Highlights, 2006

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2006

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

Americans spend nearly $2 trillion on health care each year. U.S. hospitals, physicians, nurses, and other health care providers offer some of the best care in the world, but far too many people still do not receive the quality of care that they expect, deserve, and purchase. The health care system in the United States is working to improve the quality of care. These changes require that health care providers, policymakers, and consumers get accurate, unbiased information in order to make the best decisions along with tools and practices they can use to improve the Nation's health care system. The Agency for Healthcare Research and Quality (AHRQ), 1 of 12 agencies within the Department of Health and Human Services (HHS), is committed to helping the nation improve our health care system. AHRQ's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. To fulfill this mission, AHRQ conducts and supports health services research that: Reduces the risk of harm from health care services by using evidence-based research and technology to promote the delivery of the best possible care; Transforms research into practice to achieve wider access to effective health care services and reduce unnecessary health care costs; Improves health care outcomes by encouraging providers, consumers, and patients to use evidence-based information to make informed treatment choices/decisions. The Agency's mission and goals help HHS achieve the objectives set forth in the Secretary's 2006 priority initiatives, especially those of health care transparency, health care technology, value-based health care, Medicaid modernization, personalized health care, prevention, and public health preparedness. This report presents key findings from AHRQ's research portfolio during 2006.

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ISBN 10

1499327706

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9781499327700

Ahrq Annual Highlights, 2008

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2008

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

The U.S. health care system continues to face challenges in improving the safety and quality of health care, ensuring access to care, increasing value for health care, reducing disparities, increasing the use of health information technology, and finding new avenues for translating research into practice. As reflected in the 2007 National Health Care Quality Report and National Healthcare Disparities Report, the rate of quality improvement appears to be slowing. Overall, the quality of health care improved by an average of 1.5 percent per year between the years 2000 and 2005. This represents a decline when compared with the 2.3 percent average annual rate between 1994 and 2005. Quality in some areas has improved such as counseling to quit smoking. There has been some progress in reducing disparities as reflected in the elimination of the disparity between the rates of black and white hemodialysis patients who had adequate dialysis and reduced disparities in childhood vaccinations. However, measures of patient safety showed an average annual improvement of only 1 percent. As 1 of 12 agencies within the Department of Health and Human Services (HHS), the mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, effectiveness, and cost effectiveness of health care for all Americans. The Agency fulfills this mission by developing and working with the health care system to implement information that: Reduces the risk of harm from health care services by using evidence based research and technology to promote the delivery of the best possible care; Transforms the practice of health care to achieve wider access to effective services and reduce unnecessary health care costs; Improves health care outcomes by encouraging providers, consumers, and patients to use evidence based information to make informed treatment decisions. Ultimately, the Agency's goal is to improve the quality and safety of health care. It achieves this goal by translating research into improved health care practice and policy. Health care providers, patients, policymakers, payers, administrators, and others use AHRQ research findings to improve health care quality, accessibility, and outcomes of care. Disseminating AHRQ's research findings helps support a nation of healthier, more productive individuals and an enhanced return on the Nation's substantial investment in health care. This report presents key accomplishments, initiatives, and research findings from AHRQ's research portfolio during fiscal year 2008. The Agency's mission helps HHS achieve its strategic goals to improve the safety, quality, affordability, accessibility of health care; public health promotion and protection, disease prevention, and emergency preparedness; promote the economic and social wellbeing of individuals, families, and communities; and advance scientific and biomedical research and development related to health and human services. The Agency has a broad scope that touches on nearly every aspect of health care including: Clinical practice; Outcomes of care and effectiveness; Evidence based medicine; Primary care and care for priority populations; Health care quality; Patient safety/medical errors; Organization and delivery of care and use of health care resources; Health care costs and financing; Health care system and public health preparedness; Health information technology; Knowledge transfer.

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ISBN 10

1499327781

ISBN 13

9781499327786

Ahrq Annual Highlights, 2009

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Highlights, 2009

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

Fiscal year 2009 (FY09) was an exciting year for the American health care system. An infusion of funding from the American Recovery and Reinvestment Act (Recovery Act) and the debate over health reform brought new attention to the opportunities and the challenges the system faces in improving the safety and quality of health care, ensuring access to care, increasing the value of health care, reducing disparities, and increasing the use of health information technology. The Agency for Healthcare Research and Quality's (AHRQ) Effective Health Care (EHC) Program has successfully grown into a program that is collaborative, transparent, stakeholder-driven, relevant, and timely. Our goal is to develop evidence-based information that is both rigorous and relevant to clinical decisions and is available when decisions are made. We have learned that to achieve that goal, ongoing dialogue with public and private sector stakeholders is essential. In order to gain and maintain the trust of all stakeholders, comparative effectiveness research (CER) must be fully transparent to all. Transparency has been a hallmark of the EHC Program. The transparency begins with an open process for setting research priorities, which the secretary of the Department of Health and Human Services (HHS) sets through discussion with and extensive input from stakeholders. Within the boundaries of those priorities, the public and other interested stakeholders have the opportunity to comment on the framing of specific research questions and to critique draft reports. In addition to the open invitation to comment, manufacturers are notified when a comparative effectiveness review begins on one of their products and are invited to submit relevant studies and data. Efforts to encourage outside input ensure that all stakeholders have equal and fair access to the process. Comparative effectiveness research aims to improve health outcomes by developing and disseminating evidence-based information to patients, providers, and health care decision-makers about the effectiveness of treatments relative to other options. AHRQ's comparative effectiveness research considers the effectiveness of treatments in specific subpopulations and the clinical utility and validity of genetic tests. Additionally, AHRQ supports research on the way patients and physicians receive and access the latest health care information. This research, along with information about each individual patient, can be used to optimize care for the individual and can help us achieve the vision of personalized medicine. The Agency fulfills this mission by developing and working with the health care system to implement information that: Reduces the risk of harm from health care services by using evidence-based research and technology to promote the delivery of the best possible care; Transforms the practice of health care to achieve wider access to effective services and reduce unnecessary health care costs; Improves health care outcomes by encouraging providers, consumers, and patients to use evidence-based information to make informed treatment decisions. Ultimately, the Agency achieves its goals by translating research into improved health care practice and policy. Health care providers, patients, policymakers, payers, administrators, and others use AHRQ research findings to improve health care quality, accessibility, and outcomes of care. This report presents key accomplishments, initiatives, and research findings from AHRQ's research Portfolios during FY09. The Agency's mission helps HHS achieve its strategic goals to improve the safety, quality, affordability, and accessibility of health care; promote public health, disease prevention, and emergency preparedness; contribute to the economic and social well-being of individuals, families, and communities; and advance scientific and biomedical research and development related to health and human services.

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1499327889

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9781499327885

Ahrq Annual Report on Research and Financial Management, Fy 2002

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Report on Research and Financial Management, Fy 2002

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

Over the last century, Americans have experienced unprecedented advances in health care. Average life expectancy has increased by nearly 30 years, and as a nation, we are enjoying healthier and more productive lives. We are moving closer every day in our quest to find new treatments and cures for diseases that affect millions of Americans. Much of this progress is due to the advances that have emerged from our investments in health care research. These investments have led to a strong foundation of scientific evidence that has been accumulated over time from many sources. These include basic science carried out in laboratories, clinical trials underway in hospitals and other health care settings, and health services research that is conducted by investigators in both clinical and nonclinical settings. As a result, the health care we receive today may be the most technologically sophisticated and highest quality care in the world. However, as we move ahead in this new century, it has become apparent that the care known to be effective is not always the care we receive. Indeed, all too often health care causes harm. One recent report concluded that tens of thousands die each year from errors in their care. Indeed, medical errors could be among the top 10 causes of death in the United States. Today, we are experiencing an unprecedented volume and pace of change in the U.S. health care system. These changes are not occurring uniformly across the country, and they affect different population groups in different ways. While medical science and technology continue to provide promising advances, our health care system often struggles to keep up and deliver those advances to patients in the form of improved health care. Recognizing this, the Institute of Medicine recently reported that “between the health care we have and the care we could have lies not just a gap but a chasm.” The urgency for addressing the issues underlying this chasm has increased as a result of events that occurred in the aftermath of September 11. We must find ways to respond quickly and efficiently to threats of bioterrorism and other public health emergencies. AHRQ supports and conducts health services research on health care quality, patient safety, access to care, medical effectiveness, the costs of care and how we pay for care, and many other issues that are crucial to the future health and well being of the American people. This report presents information on the programs and activities undertaken by AHRQ in FY 2002. It includes examples of some recent accomplishments and a description of the research priorities that will shape our activities in the months ahead. To set the stage for this discussion, the report describes AHRQ's organizational structure and the key responsibilities of functional components, discusses the role of the agency's National Advisory Council and identifies the various audiences and customers who use and depend on the findings from agency-supported research.

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1499383231

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9781499383232

Ahrq Annual Report on Research and Financial Management, Fy 2003

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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Ahrq Annual Report on Research and Financial Management, Fy 2003

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

AHRQ's research is driven by the needs of users—patients, clinicians, health system leaders, and policymakers. The Agency's research provides the scientific foundation for the Nation's efforts to improve the quality, safety, effectiveness, and efficiency of health care. AHRQ supports the work of health services researchers at America's leading academic centers and maintains a rigorous intramural research program that collects and analyzes data to understand changes in health care quality, cost, use, and access. AHRQ also supports efforts to develop the tools and information used by the public and private sectors to measure and improve health care quality. This FY 2003 Annual Report highlights the research and financial management efforts of the Agency for Healthcare Research and Quality and its employees to develop more efficient and effective ways to fulfill the AHRQ mission while maintaining and protecting the integrity of the resources. The report brings to light major programmatic and managerial accomplishments and serves as an important tool to measure our progress and identify future challenges. In FY 2003, AHRQ made significant progress towards implementing each of the five President's Management Agenda (PMA) initiatives: strategic management of human capital, competitive sourcing, improved financial performance, expanded electronic government, and budget and performance integration. Many steps were taken to attract, retain, motivate, and reward a quality and high-performing workforce, including revamping the recruiting and hiring programs and creating a state-of-the-art, competency-based performance management system. By realigning the work done with our strategic goals and those of the Department, the integration of budget and performance improved.

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1499383371

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9781499383379

National Healthcare Quality Report, 2008

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

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National Healthcare Quality Report, 2008

By: U.s. Department of Health and Human Services,Agency for Healthcare Research and Quality

Health care helps people stay healthy, recover from illness, live with chronic disease or disability, and cope with dying. Quality health care delivers these services in a way that is safe, timely, patient centered, efficient, and equitable. Unfortunately, Americans too often do not receive care that they need or they receive care that causes harm. Care can be delivered too late or without full consideration of a patient's preferences and values. Many times, our system of health care distributes services inefficiently and unevenly across populations. Each year since 2003, the Agency for Healthcare Research and Quality (AHRQ), together with its partners in the Department of Health and Human Services (HHS), has reported on progress and opportunities for improving health care quality, as mandated by the U.S. Congress. The information amassed for the National Healthcare Quality Report (NHQR) since its inception is a growing knowledge base that addresses two critically important questions: What is the status of health care quality in the United States? How is the quality of the health care delivered to Americans changing over time? The significance of tracking this sector's performance is evident from many vantage points. More than $2 trillion is spent each year on health care in the United States, and costs are escalating relentlessly, threatening the financial security of families and businesses. Quality and value are increasingly considered in decisions made by patients and payers. To help patients choose doctors and hospitals prudently, tools have been produced that gather information about and rate providers. To motivate providers to deliver high-quality care, purchasers are starting to reward superior performance and refusing to pay for additional care needed to correct medical errors. This is a dynamic area that will likely continue to develop and affect ways in which care is selected, delivered, and paid for. Monitoring the success of these efforts is crucial as stakeholders refine their quality improvement activities and reassure Americans that they are receiving the optimal health care they deserve. The NHQR is built on 220 measures categorized across four dimensions of quality: effectiveness, patient safety, timeliness, and patient centeredness. Guided by a subcommittee of AHRQ's National Advisory Council and an HHS Interagency Work Group, i this year's report focuses on the state of health care quality for a group of 45 core report measures that represent the most important and scientifically credible measures of quality for the Nation. By focusing on 45 core measures, the 2008 report provides a more readily understandable summary and explanation of the key results derived from the data.ii While the measures selected for inclusion in the NHQR are derived from the most current scientific knowledge, this knowledge base is not evenly distributed across the dimensions of health care quality. For example, there are many measures on the effectiveness of care for heart attacks, but few measures of medication safety or end-of-life care. The analysis in the following pages centers on measures for which data are available and fit within a framework provided by the Institute of Medicine. Three themes from the 2008 NHQR emphasize the need to accelerate progress if the Nation is to achieve high-quality health care. These themes also reflect the challenges that still remain: Health care quality is suboptimal and continues to improve at a slow pace; Reporting of hospital quality is leading improvement, but patient safety is lagging; Health care quality measurement is evolving, but much work remains.

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149934046X

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9781499340464

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