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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> &gt; <a href="." class="crumb_link">October 1997</a>
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<td><h1><a name="h1" id="h1"></a> Announcements </h1>
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<td><div id="centerContent"><div class="headnote">
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<a name="head1"></a>
<a name="head2"></a><h2>AHCPR and AAHPF issue RFA for studies on quality of care for chronic disease in managed care</h2>
<p>The Agency for Health Care Policy and Research (AHCPR) and the American Association of
Health Plans Foundation (AAHPF) have issued a joint call for studies to determine the impact of
different features of health plans on the quality of care provided to patients with chronic illnesses
and on outcomes. Together, AHCPR and AAHPF will provide up to $7 million over a 3-year
period to support peer-reviewed, outcomes-focused studies. The foundation is the research arm of
the American Association of Health Plans (AAHP), a national organization representing over
1,000 health plans that serve approximately 140 million Americans.</p>
<p>These studies are representative of a research focus that is moving beyond questions of
differences between managed and fee-for-service care or between types of health maintenance
organizations, according to John M. Eisenberg, M.D., AHCPR's Administrator. These studies
will look at how changes in organizational structures and care models being developed by health
plans impact patient health. The collaborative effort between AHCPR and AAHPF provides a
framework for impartial, scientifically rigorous studies.</p>
<p>Over 80 percent of privately insured Americans now depend on some form of managed care for
their health needs, as do roughly 30 percent of Medicaid recipients and nearly 14 percent of
Medicare beneficiaries. The two latter groups have the highest incidence of chronic illnesses&#8212;the
focus of this research. </p>
<p>This research, which addresses quality and outcomes of care for people with chronic diseases, will
focus on special populations, including women, minorities, and the elderly, and will serve as a
catalyst to encourage cooperative research with others who have a commitment to this mission.
According to Karen Ignagni, M.B.A., AAHP's president, this industry-wide research supplements
the ongoing research of AAHP's individual member plans and has the potential to greatly benefit
millions of Americans.</p>
<p>Although research to date has not been sufficiently sensitive to variations in quality or outcomes
that may result from specific features of health plans, studies have uncovered a number of
challenges for both managed care and fee-for-service plans. These include the need for greater
compliance with well-established guidelines for caring for patients with chronic illnesses and the
need to assess chronically ill patients' understanding of their condition and examine their
functional ability.</p>
<p>The new research solicitation calls for studies focusing on widespread chronic conditions or
aggregations of conditions, especially if they have a disproportionate impact on children, women,
minorities, or the elderly. Health plan features that researchers may want to study because they
may affect performance include the availability of specialists and subspecialists, types of providers
involved in primary care, and methods for influencing provider practice, including
risk-sharing.</p>
<p>The announcement, "Quality of Care Under Varying Features of Managed Care
Organizations," is available <a href="/fund/98004.htm">online</a>.</p>
<p>Prospective applicants are asked to submit a letter of intent by November 31, 1997, that includes
a descriptive title of the proposed project; the name, address, and telephone number of the
principal investigator and other key personnel; and the number and title of this RFA. Letters of
intent should be sent to either Bernard Friedman, Ph.D., Center for Organization and Delivery
Studies, or James Cooper, M.D., Center for Primary Care Research, Agency for Health Care
Policy and Research, 2101 East Jefferson Street, Rockville, MD 20852. The deadline for
applications is January 6, 1998. See the application kit for submission information.</p>
<p>This Request for Applications (RFA HS-98-005) was published September 19, 1997, in volume
26, number 31, of the <em>NIH Guide to Grants and Contracts</em>.</p>
<p>For more information about this research, contact Bernard Friedman, Ph.D., at AHCPR's Center
for Organizational and Delivery Studies, (301) 427-1404; E-mail: BFriedma@ahrq.gov. </p>
<a name="head3"></a><h2>New publications available from AHCPR</h2>
<p>The following publications were published recently by the Agency for Health Care Policy and
Research. </p>
<p><strong><em>A Compendium of Selected Public Health Data Sources: A Working Document</em>.</strong> </p>
<p>This document is an important resource for those interested in locating health data. Its 250-plus pages describe 76 electronic and hard-copy sources of data from Federal and non-Federal entities on a broad
array of health-related topics ranging from youth risk-behavior to older Americans. For each
entry, the <em>Compendium</em> provides a general description of the activity, a brief but detailed
explanation of the data content, information on access to the data, and a contact. Appendixes list
Bureau of the Census State Data/Information Centers, agency heads and contact persons for
designated State Centers for Health Statistics, public health officials who are part of the Center
for Disease Control and Prevention's information network, and World Wide Web addresses for
State health agencies and related organizations. In addition, an overview of the Health Care
Financing Administrations data files is included. Copies of <em>A Compendium of Selected Public
Health Data Sources: A Working Document</em> (AHCPR Publication No. 97-0004) are available
from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</p>
<p><strong><em>AHCPR Program Notes</em>.</strong></p> <p>AHCPR's Center for Organization and Delivery Studies recently published three Program Notes that summarize ongoing and completed AHCPR research on
managed care, long-term care, and the Medicaid Program.</p>
<ul>
<li><strong><em>AHCPR Research About Managed Care</em>. Program Note 3</strong> (AHCPR Publication No.
97-0023). Because the health care system has changed so rapidly and extensively, little is
known about the long-term effects of managed care on access to care, cost, and quality of
care. This <em>Program Note</em> reviews a wide range of AHCPR studies on managed care, the
vast majority of which were conducted on health maintenance organizations (HMOs), the
prototypic managed care organization. Research is reviewed by category: changes in health
care markets; organization and delivery of services; impact on clinical decisionmaking, access,
and quality; interventions that improve outcomes; impact on cost; rural studies; and tools to
measure quality. Copies of <em>AHCPR Research About Managed Care</em> (AHCPR Publication No. 97-0023) are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</li>
<li><strong> <em>AHCPR Research on Long-Term Care</em>. Program Note 4</strong> (AHCPR Publication No.
97-0054). Long-term care is an increasingly important and rapidly changing part of today's
health care delivery system. The need for long-term care services continues to grow, placing
financial pressure on both individuals and governments and fueling unprecedented changes in
the health care marketplace. In turn, changes in market and delivery systems are raising
questions about the appropriateness, cost, and quality of services delivered in different settings.
AHCPR has undertaken and funded studies in long-term care to provide answers to
fundamental questions by purchasers, providers, consumers, and policymakers. This <em>Program
Note</em> summarizes the results of AHCPR research in six broad areas of investigation: use, cost,
and financing; access and quality of care; organization and delivery of care; consumer and
caregiver behavior; special populations; and data development and methodology. Copies of <em>AHCPR Research on Long-Term Care</em> (AHCPR Publication No. 97-0054) are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</li>
<li> <strong><em>Meeting Medicaid's Cost and Quality Challenges: The Role of AHCPR
Research</em>. Program Note 5</strong> (AHCPR Publication No. 97-0044). Medicaid
program costs increased dramatically in the late 1980s and early 1990s due to rapid expansion of eligibility, a national recession, inflation in health care spending, and State use of statutory loopholes to leverage Federal dollars. Partly to control costs, the Medicaid program has moved rapidly toward using
managed care. AHCPR has been (1) providing science-based research to support Federal and
State efforts, (2) disseminating research findings and guidelines that managed care plans and
providers servicing the Medicaid population can use to lower costs and improve quality, and
(3) providing technical assistance to State policymakers and administrators seeking to improve
their Medicaid programs. AHCPR's research and technical assistance falls into six areas: care
for elderly and disabled populations, maternal and child health, research and technical
assistance on HIV and AIDS, drug policy, informing consumers, and system financing and
management. Copies of <em>Meeting Medicaid's Cost and Quality Challenges</em> (AHCPR Publication No. 97-0044) are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</li>
</ul>
<p><strong><em>El paciente y los medicamentos de receta: Una guia para el paciente</em>.</strong></p> <p>The popular consumer guide, <em>Prescription Medicines and You</em>, recently published in English by AHCPR, is now available in Spanish. It can help Spanish-speaking consumers&#8212;particularly elderly
consumers&#8212;avoid potentially dangerous mistakes involving prescription medicines and learn how and to whom they can talk about their medications. The brochure was developed by AHCPR in partnership with the
National Council on Patient Information and Education.</p>
<p>This 17-page brochure describes common mistakes patients make with their medications, such as
deciding to stop taking a medicine before they are supposed to or not taking the proper dosage. It
also explains how patients can work with their physicians to make decisions about treatment plans
that involve prescription drug use, talks about reporting side effects and other information to the
physician or nurse, and suggests questions to ask the doctor or nurse about the use of prescription
medicines.</p>
<p>The guide, <em>El paciente y los medicamentos de receta: Una guia para el paciente</em> (AHCPR
Publication No. 97-0002; in English 96-0056), is available free (in single or bulk copies) from the
<a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse.</a></p>
<p><strong>Hospital Cost and Utilization Project (HCUP-3).</strong></p> <p>HCUP-3 is a
Federal-State-industry partnership to assemble encounter-level health care data that are publicly available for use in health services research and health policy analysis. The HCUP-3 National Inpatient Sample (NIS)
contains discharge records from a 20 percent nationally representative sample of U.S. community
hospitals. The database contains clinical, demographic, hospital, and census data for each
discharge and includes all payers. Currently, 17 partner States contribute State-wide data to the
HCUP-3 NIS project. At this time, NIS data are available though 1994; 1995 data will become
available in January 1998.</p>
<p>AHCPR recently published three <em>HCUP-3 Pocket Guides</em> that show summary statistics by
three classification schemes&#8212;diagnosis-related groups (DRGs), principal procedures, and
principal diagnoses. Summary statistics are shown for the number and percent of discharges, mean lengths
of stay, and mean total charges. These 4 1/2" x 7" publications are designed to be handy guides
for use by researchers, hospital planners, market analysts, policymakers, and others. </p>
<p>DRGs are accompanied by a crosswalk showing the major diagnostic categories (MDCs) to which
their subject areas correspond. Procedures and diagnoses are classified according to the Clinical
Classifications for Health Policy Research (CCHPRs). The CCHPRs were developed by AHCPR
researchers as a way to classify diagnoses and procedures into mutually exclusive and clinically
meaningful categories for use in aggregate statistical reporting. The CCHPRs' description and
algorithm are publicly available and are being updated through September 1998.</p>
<p>The three <em>Pocket Guides</em> are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a> as follows: </p>
<ul>
<li>Diagnosis-Related Groups (AHCPR Publication No. 97-0056).</li>
<li>Principal Diagnoses (AHCPR Publication No. 97-0058).</li>
<li>Principal Procedures (AHCPR Publication No. 97-0057).</li>
</ul>
<p><strong>Medical Expenditure Panel Survey (MEPS).</strong> </p><p>MEPS is the third in a series of nationally representative surveys of medical care use and expenditures sponsored by AHCPR. MEPS is cosponsored by the National Center for Health Statistics (NCHS). The first of these surveys, the National Medical Care Expenditure Survey (NMCES), was conducted in 1977, and the second, the National Medical Expenditure Survey (NMES), in 1987.</p>
<p>MEPS collects detailed information on health care use and expenses, sources of payment, and
insurance coverage of individuals and families in the United States at different intervals and over
time. Select for a more complete <a href="/research/may97/ra3.htm#releases">description</a> of MEPS or access <a href="http://www.meps.ahrq.gov/">materials related to MEPS</a> on the AHCPR Web site. </p>
<p>The second in a series of <em>MEPS Highlights</em> and the first two <em>MEPS Methodology Reports</em> are now available from AHCPR: </p>
<ul>
<li><strong><em>Characteristics of Nursing Home Facilities and Residents</em>. Nursing Home
Update 1996; MEPS Highlights No. 2.</strong> This publication presents information gathered from a nationally representative sample of nursing homes during the first half of 1996. It covers nursing home
size and ownership, continuum of care, functional status of residents, use of advance
directives, and Medicare and Medicaid enrollment. Copies of <em>MEPS Highlights No. 2</em> (AHCPR
Publication No. 97-0036) are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications
Clearinghouse</a>.</li>
<li><strong><em>Design and Methods of the Medical Expenditure Panel Survey Household Component</em>.
MEPS Methodology Report No. 1.</strong> The Household Component (HC) of MEPS collects
detailed data on demographic characteristics, health conditions, health status, use of medical
care services, charges and payments, access to care, satisfaction with care, health insurance
coverage, income, and employment. This report describes the design and methods of the 1996
MEPS HC, including comparability with other medical expenditure surveys, relationship to the
National Health Interview Survey, preliminary contact and rounds of data collection, and
survey instruments. The types of statistics produced by the MEPS HC and uses of the data are
described. In addition to producing annual estimates for a variety of health care measures, the
data can be used for analyses to inform researchers and policymakers about how the
characteristics of individuals and families, including their health insurance, affect medical care
use and spending. In conjunction with data from earlier expenditure surveys, these data can be
used to study trends in the nature and distribution of national health expenditures, sources of
care, and amounts and types of services used by the U.S. noninstitutionalized population.
Copies of <em>MEPS Methodology Report No. 1</em> (AHCPR Publication No. 97-0026) are
available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</li>
<li><strong><em>Sample Design of the 1996 Medical Expenditure Panel Survey Household Component</em>.
MEPS Methodology Report No. 2.</strong> As part of its "reinventing government" activities, the
Department of Health and Human Services developed a survey integration plan. This report
describes enhancements and efficiencies incorporated into MEPS as a result of survey
integration, such as cost savings, enhanced analytic capacity, increased opportunities for
longitudinal analyses, reduction of major data gaps, and improvements in the timeliness of data
release. The sample design of the Household Component, which uses NCHS National Health
Interview Survey as its frame, is described. Sampling unit definitions, eligibility criteria, sample
size targets, and precision requirements are discussed. Copies of<em> MEPS Methodology Report
No. 2</em> (AHCPR Publication No. 97-0027) are available from the <a
href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHCPR Publications Clearinghouse</a>.</li>
</ul>
<a name="head4"></a><h2>AHCPR funds new projects</h2>
<p>The following new projects were funded recently by the Agency for Health Care Policy and
Research. Readers are reminded that the results of studies usually are not available or published
until a project is completed or nearing completion. </p>
<h3>Conference Grants</h3>
<p><strong>Emergence of hospitalists in American health care</strong></p>
<p>Project director: Robert M. Wachter, M.D.<br />
Organization: University of California<br />
San Francisco, CA<br />
Project number: AHCPR grant HS09541<br />
Period: 9/1/97 to 5/31/98<br />
Funding: $46,658</p>
<p><strong>Oral health 2000 national consortium: Grassroots synergy</strong></p>
<p>Project director: Denise S. Lebloch, B.S.<br />
Organization: Oral Health America<br />
Chicago, IL<br />
Project number: AHCPR grant HS09546<br />
Period: 9/1/97 to 2/28/98<br />
Funding: $10,000</p>
<p><strong>Quality criteria for health information on the Internet</strong></p>
<p>Project director: Helga E. Rippen<br />
Organization: Mitretek Systems, Inc.<br />
McLean, VA<br />
Project number: AHCPR grant HS09549<br />
Period: 9/30/97 to 9/28/98<br />
Funding: $10,000</p>
<p><strong>Toward a women's health outcomes research agenda</strong></p>
<p>Project director: Margaret A. Anderson, M.A.<br />
Organization: Society for the Advancement of Women's Health Research<br />
Washington, DC<br />
Project number: AHCPR grant HS09548<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $45,000 </p>
<h3>Dissertation Grants</h3><p>
<strong>Competition and the quality of hospital care</strong></p>
<p>Project director: June F. O'Leary, M.S.<br />
Organization: University of California<br />
Los Angeles, CA<br />
Project number: AHCPR grant HS09681<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $32,400</p>
<p><strong>Medical practice guidelines for contrast media</strong></p>
<p>Project director: John B. Hernandez, B.A.<br />
Organization: RAND Corporation<br />
Santa Monica, CA<br />
Project number: AHCPR grant HS09686<br />
Period: 9/30/97 to 5/31/98<br />
Funding: $29,987</p>
<p><strong>Provider risk-sharing in managed care</strong></p>
<p>Project director: Meredith B. Rosenthal, A.B.<br />
Organization: Harvard Medical School<br />
Boston, MA<br />
Project number: AHCPR grant HS09660<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $22,233</p>
<p><strong>PPS impact on hospital-based skilled nursing units</strong></p>
<p>Project director: Stuart A. Hagen, M.B.A.<br />
Organization: Harris Graduate School of
Public Policy<br />
Chicago, IL<br />
Project number: AHCPR grant HS09676<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $26,082</p>
<h3>Research Grants/Cooperative Agreements</h3><p>
<strong>Impact of guidelines on quality of care: Unstable angina</strong></p>
<p>Project director: Catarina I. Kiefe, M.D., Ph.D.<br />
Organization: University of Alabama<br />
Birmingham, AL<br />
Project number: AHCPR grant HS08843<br />
Period: 9/30/97 to 9/29/00<br />
First year funding: $472,648</p>
<p><strong>Market power and efficiency effects in hospital mergers</strong></p>
<p>Project director: Gloria J. Bazzoli, Ph.D.<br />
Organization: Hospital Research and
Educational Trust<br />
Chicago, IL<br />
Project number: AHCPR grant HS09201<br />
Period: 9/30/97 to 4/30/99<br />
First year funding: $229,201</p>
<h3>Small Project Grants</h3><p>
<strong>Comparing mean costs before and after a policy change</strong></p>
<p>Project director: Xiao-Hua Zhou, Ph.D.<br />
Organization: Indiana University<br />
Indianapolis, IN<br />
Project number: AHCPR grant HS09543<br />
Period: 9/1/97 to 3/31/99<br />
Funding: $25,196</p>
<p><strong>Evaluation of a model of managed care for SCD patients</strong></p>
<p>Project director: Thomas R. Konrad, Ph.D.<br />
Organization: Sheps Center for Health Services Research<br />
Chapel Hill, NC<br />
Project number: AHCPR grant HS09553<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $71,194</p>
<p><strong>Experience of low-income women with breast cancer</strong></p>
<p>Project director: Anne S. Kasper, Ph.D.<br />
Organization: University of Illinois <br />
Chicago, IL<br />
Project number: AHCPR grant HS09558<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $67,712</p>
<p><strong>Factors affecting bargaining between pharmacists and insurers</strong></p>
<p>Project director: John M. Brooks, Ph.D.<br />
Organization: University of Iowa<br />
Iowa City, IA<br />
Project number: AHCPR grant HS09541<br />
Period: 9/1/97 to 8/31/98<br />
Funding: $73,500</p>
<p><strong>Hospitals' strategic responses to competitive markets</strong></p>
<p>Project director: Dana B. Mukamel, Ph.D.<br />
Organization: University of Rochester<br />
Rochester, NY <br />
Project number: AHCPR grant HS09545<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $79,365</p>
<p><strong>Impact of managed care on African Americans</strong></p>
<p>Project director: Mahmud Hassan, Ph.D.<br />
Organization: University of Alabama<br />
Birmingham, AL<br />
Project number: AHCPR grant HS09569<br />
Period: 9/30/97 to 1/31/99<br />
Funding: $53,119</p>
<p><strong>Medicaid changes: Impact on at-risk children</strong></p>
<p>Project director: Laurel K. Leslie, M.D.<br />
Organization: Childrens Hospital Research Center<br />
San Diego, CA<br />
Project number: AHCPR grant HS09563<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $39,317</p>
<p><strong>Ownership status, market concentration, and hospital pricing</strong></p>
<p>Project director: Gary J. Young, Ph.D.<br />
Organization: Boston University<br />
Boston, MA<br />
Project number: AHCPR grant HS09568<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $61,153</p>
<p><strong>Primary care physicians' participation in Medicaid managed care</strong></p>
<p>Project director: Andrew B. Bindman, M.D.<br />
Organization: University of California<br />
San Francisco, CA<br />
Project number: AHCPR grant HS09557<br />
Period: 9/30/97 to 9/29/98<br />
Funding: $73,322 </p>
<p><strong>Attention Researchers: </strong> The Department of Health and Human Services has launched GrantsNet, an online resource to help you locate and access information about grant programs available
through HHS and selected other Federal departments. It can help you: </p>
<ul>
<li>Find grant information.</li>
<li>Search for funding.</li>
<li>Learn how to apply for a grant.</li>
</ul>
<p>The site also includes information on administering grants, a calendar of events pertaining to
grants, and other topics of interest to potential applicants. Be sure to visit GrantsNet at: <a href="http://www.hhs.gov/grantsnet/">http://www.hhs.gov/grantsnet/</a></p>
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