Research Activities

January/February 1999, No. 223


Contents

About Research Activities

Feature Story

Publicizing bypass surgery outcomes has not prompted doctors to deny surgery to higher risk elderly patients

Departments

Outcomes/Effectiveness Research
   Heart failure accounts for much of the variation among surgeons in bypass surgery mortality rates
   Only a small number of heart attack patients may benefit from prophylactic use of implanted automatic defibrillators
   People at risk for major stroke vary widely in their values and treatment preferences
   Negative provider attitudes toward diabetes and its management may be barriers to better care for diabetic adults
   Researchers examine treatment and outcomes for low back pain
   Patient factors rather than differences in medical management affect visual acuity after cataract surgery

Children's Health
   Researchers examine neonatal ICU practices, triage, improvements in care, and the use of narcotics
   Expanding Medicaid prenatal support services reduces rate of low birthweight infants
   More than one-third of America's children lacked proper immunizations in the early 1990s
   Despite some concerns, most primary care doctors recommend early childhood hepatitis B vaccination
   Half of Medicaid-insured children never visit a dentist, and many who do are not given needed care

Health Care Use and Access
   Computerized guidelines reduce prescribing by hospital doctors of an expensive and overprescribed antibiotic
   Financial incentives and performance feedback to physicians may not increase cancer screening for Medicaid enrollees
   Canada and the United States differ greatly in their hospital use for back and neck problems

Managed Care/Primary Care
   Managed care hospital report cards may not allow for differences among patients
   Several factors affect the variability of managed care penetration across health care markets
   Collaboration among competing clinics can enhance adult preventive care

Hospital Issues
   Community perceptions and commitment affect the survival of rural hospitals
   Inappropriate ER visits may stem from social rather than medical needs

Health Care Costs and Financing
   More expensive drugs, fewer deaths, and steady HIV infection rates mean costs of AIDS care continue to rise
   Lowering Medicaid coverage for anti-ulcer drugs reduced their use without increasing hospitalization
   Even a small amount of choice in health plans might improve public confidence in health insurance

Long-Term Care
   Ownership type is an important factor in determining nursing home outcomes
   Nursing home subsidies should be targeted to those who need them most
   Nursing home residents and their families often have little input into end-of-life medical decisions

Quality of Care
   Parents can play an important part in developing and disseminating pediatric practice guidelines
   A new quality improvement tool is being developed for deriving benchmarks of clinical care
   Everyone should be concerned about health care quality

Medical Education
   Despite some differences, chiropractic and medical education have a lot in common

AHCPR News and Notes
   AHCPR names first Child and Adolescent Health Scholar

Announcements
   Applications due April 22 in response to three new RFAs
   AHCPR's Web-based National Guideline Clearinghouse™ is now online
   AHCPR releases four new evidence reports/technology assessments

Research Briefs
   Comparison of the Quality of Well-being Scale and the SF-36 results among two samples of ill adults: AIDS and other illnesses
   Meta-analysis of multiple outcomes by regression with random effects
   Mortality, symptoms, and functional impairment in late-life depression
   Attitude and self-reported practice regarding prognostication in a national sample of internists
   A method for estimating solid organ donor potential by organ procurement region
   Outcome measures for low back pain research: A proposal for standardized use
   Selective cervical spine radiography in blunt trauma: Methodology of the National Emergency X-Radiography Utilization Study (NEXUS)
   Daily life in very old age: Everyday activities as expression of successful living
   Canopy computing: Using the web in clinical practice
   Outcomes and effectiveness research in the private sector
   Effects of computer-based prescribing on pharmacist work patterns
   Pre-AIDS physical disability: Data from the AIDS time-oriented health outcome study
   What if socioeconomics made no difference? Access to a cadaver kidney transplant as an example
   Determinants of home health visit length
   Effect of local standards on the implementation of national guidelines for asthma
   Empirically defined health states for depression from the SF-12
   Hidden spears: Handlebars as injury hazards to children
   Changes in the SF-36 in 12 months in a clinical sample of disadvantaged older adults


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