Three new publications, two research reports and a chartbook, are now available from the Agency for Healthcare Research and Quality. The reports and chartbook are available from the AHRQ Publications Clearinghouse.
Managing Osteoarthritis: Helping the Elderly Maintain Function and Mobility. Research in Action, Issue 4 (AHRQ Publication No. 02-0023).
This report is a synthesis of AHRQ research on osteoarthritis in the elderly. For example, AHRQ research has shown that the disabling effects of osteoarthritis can be reduced or prevented through the use of patient self-management of the kind promoted by the Chronic Disease Self-Management Program. Occupational therapy to evaluate a person's ability to perform daily activities and recommend devices to help them perform these activities also can be useful. In addition, AHRQ studies indicate that nonsteroidal antiinflammatory drugs (NSAIDs), used to control pain associated with osteoarthritis, can cause complications such as upper gastrointestinal bleeding or peptic ulcer disease. AHRQ researchers have indicated that acetaminophen is the recommended drug of choice for arthritis. Finally, although the elderly suffer proportionately more complications and adverse effects from surgical therapy than younger patients, knee replacement surgery can provide pain relief and functional improvement for elderly patients with osteoarthritis. Complication rates are lower for surgical procedures performed by surgeons who do more than 20 knee replacements per year and in hospitals that perform at least 40 knee replacement operations per year.
Expanding Patient-Centered Care to Empower Patients and Assist Providers. Research in Action, Issue 5 (AHRQ Publication No. 02-0024).
This report describes tools developed through AHRQ sponsorship that are currently available to help patients and their providers make better health care decisions. Patient-centered measures of health are most applicable for non-emergency, non-life-threatening conditions. For example, the American Urological Association's Prostate Symptom Index, which is used to choose treatment for benign prostatic hypertrophy, and the Visual Function-14 Index, often used to decide whether to perform cataract surgery, are based on patients' everyday activities. The report also discusses a consumer survey to help people choose health plans (the Consumer Assessment of Health Plans Study or CAHPS®) and several AHRQ publications about choosing health plans, obtaining quality care, avoiding medical errors, and getting preventive care.
The Uninsured in America: 1996-2000. MEPS Chartbook No. 9. (AHRQ Publication No. 02-0027), by Rhoades, J.A., Vistnes, J.P., and Cohen, J.W.
This report presents charts and data from AHRQ's Medical Expenditure Panel Survey (MEPS). It shows changes over time in the non-elderly population's risk of being uninsured. The number of uninsured Americans under age 65 varied up to two-fold depending on the time period used to define being uninsured. Numbers were highest for Americans uninsured at some point during the year, lowest for those uninsured all year, and in between for those uninsured throughout the first half of the year. The percent of the population uninsured at some point during the year declined from 27.0 percent in 1996 to 25.1 percent in 1999. Of all age groups, young adults (ages 18-24 years) are the mostly likely to be uninsured. In each year 1996-99, about 11 million young adults were uninsured at some point during the year. Hispanics were the racial/ethnic group most at risk of lacking coverage. Although estimates for whites and blacks show an improvement from 1996 to 1999, Hispanics did not experience any improvement. Finally, the chartbook shows that wage earners with low hourly wages and those working in small establishments had a greater risk of being uninsured.