Contents

Feature Story

• The challenge of prioritizing care for complex patients

Chronic Disease

• Metformin just as effective as other medications for treating type 2 diabetes
• Fewer heart bypass surgeries performed
• Administrative data alone are insufficient to understand equivalence of two common blood pressure drugs
• HIV/AIDS drugs have varied effects on lipid levels

Patient Safety and Quality

• Surgical risk score does not work well for knee and hip replacement operations
• Pay-for-performance project showed early gains but tapered in the fourth and fifth years

Emergency Medicine

• Leaving the emergency department without being seen more likely at hospitals that serve more low-income patients
• Patients with sepsis fare better when admitted via the emergency department rather than directly to the hospital

Disparities/Minority Health

• Blacks who receive heart transplants have poorer survival than other racial groups
• Minority status has no effect on patient outcomes in the intensive care unit
• Minority patients with nonsmall-cell lung cancer are less likely to receive hospice services than whites
• Diagnosing and treating depression gets better in nursing homes but some disparities remain

Health Care Costs and Financing

• Where low-wage employees work, who their colleagues are, and spouses' wage level affect health insurance coverage and cost
• Rising health care costs may have spurred more individuals to use complementary and alternative medicine
• A program for laboratory monitoring of renin-angiotensin system drugs is cost-effective for certain high-risk patients
• Uninsured patients respond well to paying a monthly retainer for primary care services
• Children's underenrollment in State health insurance programs may be due in part to parents' confusion about coverage
• Low- and middle-income children with public and private insurance have similar rates of unmet health care needs

Child/Adolescent Health

• Clinicians cautioned about use of antihypertensive in children receiving kidney transplants who take tacrolimus
• Friends' behavior and parental values influence rates of unprotected vaginal intercourse among teens
• A standard enzyme assay may help screen for rickets in breast-fed infants not given vitamin D supplements
• The quality of children's asthma care is affected by emergency department crowding

Health Information Technology

• Computer system compares well with clinicians in assessing, but not treating children with asthma
• Providers perceive e-prescribing as being very efficient

Elderly/Long-Term Care

• Informal caregivers of older adults need more practical information to care for loved ones
• Anxiety is common among older adults receiving care from aging services agencies

Agency News and Notes

• Heart disease, cancer, and mental disease among the most costly conditions for women
• Drug expenses for children with asthma more than doubled in 10 years
• Arizona and Maryland see great drop in in-hospital deaths from pneumonia
• How much employees pay for health care coverage depends on where they live

Announcements

• Brief outlines strategies to put patients at the center of primary care
• AHRQ releases new CME/CE activities
• 2009 HCUP Kids' Inpatient Database (KID) now available
• AHRQ releases MONAHRQ Version 2.0
• Data Points report on disease prevalence and Medicare reimbursement is available
• HCUP Data Users' Workshop registration closing soon
• AHRQ releases new series on closing the quality gap