Contents

Feature Story

• Health care quality gaps and disparities persist in every State
• From the Director

Disparities/Minority Health

• Americans, especially blacks, spend substantial periods of time uninsured
• Language barriers related to increased hospital readmissions for Chinese- and Spanish-speaking patients
• Foreign-born patients are more likely to have a form of tuberculosis that resists a common drug used in treatment

Patient Safety and Quality

• Delays in reporting medical errors at Japanese hospital nearly triple that of United States hospital
• Hospitals with a teamwork culture have better patient safety climates
• Quality measures are not used with all patients who suffer heart attacks
• Studies examine safety of pain killers among older adults
• Immersive simulation training for CPR shows no benefit over standard training

Acute Care/Hospitalization

• Patients who suffer strokes and are seen at designated stroke centers fare better in the short and long run
• Trauma center patients treated after hours or on weekends have no difference in mortality rates
• A high percentage of patients with sickle cell disease self-discharge from hospital care
• Two approaches help identify cardiac surgery patients at risk for postoperative kidney failure

Primary Care

• Communication problems between hospitalists and primary care providers lead to postdischarge problems for seniors
• Many primary care patients are at risk for obstructive sleep apnea, but few are sent for testing
• Guideline familiarity does not equal guideline adherence
• Chronic Care Model linked to exercise discussions during primary care office visits for diabetes

Chronic Disease

• Metformin remains the medication of first choice in treating type 2 diabetes
• Empowerment approach to diabetes education works better than the traditional didactic approach
• Preventive care for patients with lupus could be improved
• Trends in treating depression favor psychotropic medications over psychotherapy

Outcomes/Effectiveness Research

• Some patients hospitalized for stroke more likely to keep taking drugs to prevent another stroke
• Sleep apnea and pulmonary hypertension affect in-hospital outcomes of noncardiac surgery
• Certain factors linked to risk of early death of intensive care patients after discharge
• Physicians more reluctant to deactivate some life-sustaining devices than others
• Mandated increases in nurse staffing levels unevenly affect uncompensated care growth rates in California hospitals

Women's Health

• No link found between chemotherapy in older women with breast cancer and later cognitive impairment
• Women's self-reported stress seems to jibe with a common stress biomarker
• Mothers' medical appointments may be a link to getting daughters vaccinated for human papillomavirus
• U.S.-born Mexican women who have adopted U.S. culture may be more at risk for cervical cancer
• Pelvic ultrasound imaging by emergency physicians is highly effective in ruling out ectopic pregnancy

Child/Adolescent Health

• Antibiotics are modestly more effective than no treatment for middle ear infections in children
• Health insurance is necessary but not sufficient for children's access to care

Health Literacy

• A simple question identifies patients with low health literacy

Agency News and Notes

• AHRQ, Ad Council launch Conozca las preguntas campaign
• School-age children treated most often for sports-related concussions
• More rural Americans treated in emergency departments for eye injuries
• ICUs in Michigan sustain zero bloodstream infections for up to 2 years
• Over 3 million look to hospitals for headache relief
• Most American women experience complications during delivery
• Readmissions in 30 days or less account for 1 in 9 hospital admissions
• Report shows physicians view e-prescribing features as cumbersome
• Connecting local providers to academic medical centers using video improved hepatitis C outcomes

Announcements

• AHRQ's 2011 Annual Conference set for September 18-21
• AHRQ toolkit helps to prevent hospital-acquired pressure ulcers
• Stereotactic body radiation therapy reviewed
• Evidence report on safety of probiotics published
• Guide helps consumers reduce medication errors
• Evidence report examines health IT impact on medication management
• AHRQ releases new report on pain management of hip fracture
• Opportunities for advancing delivery system research—AHRQ meeting summary now online
• Important information about CHIPRA core set of recommended health care quality measures released

Research Briefs