Contents

Feature Story

• Health care quality still improving slowly, but disparities and gaps in access to care persist
• From the Director

Disparities/Minority Health

• Regional poverty boosts adults' chances of having unmet health care needs
• Blacks less likely than whites to use either statins or aspirin in the prevention of cardiovascular disease
• Korean Americans with high blood pressure who are confident they can achieve blood pressure control are more likely to do so

Patient Safety and Quality

• Medication safety indicators can guide improvement in primary care drug selection, dosing, and monitoring
• Hospital Compare data may not help surgical patients find hospitals with better outcomes

Chronic Disease

• Obese patients with hypertension and diabetes have a greater risk of dying after noncardiac surgery
• Medications differ in their effect on risk of foot ulcers and limb amputations in patients with diabetes
• Diet and medication adherence can reduce cardiovascular disease for patients with type 2 diabetes
• Provider's communication style boosts results for acupuncture on arthritic knees

Outcomes/Effectiveness Research

• Certain hospital characteristics influence mortality after complications following high-risk surgery
• Various factors influence the adoption of ergonomics in health care organizations

Health Care Workforce

• Nursing shortage may have adverse impact on public health emergency preparedness
• Physicians cultivate colleagues' esteem differently at low- and high-prestige hospitals

Health Care Costs and Financing

• Some adults with disabilities covered by Medicaid have significant out-of-pocket health expenses
• Medicare Part D enrollees have higher cost-sharing amounts for brand name prescription drugs than those in employer plans
• Many patients with diabetes who reach the Medicare Part D drug coverage gap don't talk about drug costs with their doctors
• Payment reform highlighted in special journal issue

Health Information Technology

• Parents using electronic kiosk provide more accurate clinical information than emergency room providers
• Decision support intervention prompts clinicians to update patients' problem lists in their medical records
• Patients with limited health literacy less likely to use an Internet portal for diabetes and other health information
• Parents find telemedicine care of children in school and childcare to be helpful and convenient

Child/Adolescent Health

• Electronic health record decision support improves the care of children with ADHD
• Adolescents with higher socioeconomic status at greater risk for substance abuse during early adulthood
• Adverse drug event surveillance tailored to hospitalized children

Women's Health

• Perceived lower social standing linked to unplanned pregnancies
• Certain women are at greater risk for mental health problems during pregnancy

Agency News and Notes

• Rates of pneumonia dramatically reduced in patients on ventilators in Michigan intensive care units
• One in four U.S. adults reported having high blood pressure in 2008
• Nearly 4 million adults reported being treated for kidney disease between 2003 and 2007
• Spending for prescriptions to control diabetes, cholesterol, and other metabolic conditions exceeds $52 billion
• Patients' income and where they live influence hospitalization for chronic lung disease

Announcements

• U.S. Preventive Services Task Force updates vision screening recommendation for young children
• New AHRQ resource helps to improve nursing home care
• AHRQ releases Common Formats for patient safety reporting in skilled nursing facilities
• New AHRQ podcasts focus on coronary artery disease, reducing medication costs, and telemedicine in schools
• New AHRQ report on women at risk for diabetes is available
• CME module offered on in-hospital off-label uses of recombinant factor VIIa
• Clarification

Research Briefs