Date: Mon, 24 Jan 1994 12:35:19 -0400 (EDT) From: "ANNE WILSON, CDC NAC" Subject: AHCPR Agency Review AGENCY FOR HEALTH CARE POLICY AND RESEARCH (AHCPR) PROFILE Mission: Improve the quality and effectiveness of health care, broaden access to services, and reduce health care costs. Established: December 1989; replaced the National Center for Health Services Research and Health Care Technology Assessment. Status: AHCPR is an agency of the Public Health Service within the U.S. Department of Health and Human Services. Employees: AHCPR has 277 employees, including experts in health policy, medicine, nursing, economics, epidemiology, sociology, and statistics. Budget: $154.4 Million for FY 1994 MEDICAL TREATMENT EFFECTIVENESS Clinical Practice Guideline Development - AHCPR facilitates development, publication, and widespread dissemination of clinical practice guidelines. The guidelines are developed by private-sector panels of physicians, nurses, other health care experts, and consumers, and by contract with nonprofit entities. Guidelines are based on research findings and expert opinion. Topics include: * acute pain * mammography * cancer pain * otitis media (middle ear infection) * heart failure * urinary incontinence * cardiac rehabilitation * HIV illness * pressure ulcer prevention * cataracts * stroke rehabilitation * benign, enlarged prostate * depression * sickle cell disease * pressure ulcer treatment * low back pain * Alzheimer's disease * anxiety/panic disorders * smoking cessation/prevention * unstable angina Outcomes Research - AHCPR supports the largest number of medical treatment effectiveness studies in the United States, including 14 patient Outcomes Research Teams (PORTs) - $5-6 million, 5-year, multisite research projects. PORTs examine alternative methods for diagnosing, treating, managing, or preventing a particular condition to determine which methods work best. Conditions under study include: * heart attack * cataracts * stroke prevention * prostate disorders * diabetes * hip fracture & osteoarthritis * schizophrenia * pneumonia * ischemic heart disease * childbirth * gallbladder disease * prevention of low birthweight * low back pain * total knee replacement Minority Research Centers - As part of its effort to improve the health of underserved minority populations, AHCPR supports research centers in various cities to find the most effective ways of preventing, detecting, treating, or managing health problems that disproportionately affect African Americans, Hispanics, Asians and Pacific Islanders, and American Indians. Data Development - AHCPR works to improve the quality and quantity of data for use in patient outcomes and other health services research. This effort includes: establishing uniform methods of developing and collecting data and investigating the feasibility of linking data bases maintained by the Federal Government, State governments, and the private sector. Health Technology Assessment - AHCPR evaluates risks, benefits, and effectiveness of new or unestablished medical devices, procedures, and other health care technologies such as: * home uterine monitoring * autologous bone marrow transplantation * laparoscopic cholecystectomy * cardiac rehabilitation services * drug infusion pumps RESEARCH ON HEALTH CARE COSTS, QUALITY, AND ACCESS AHCPR intramural and extramural programs address key issues for the health care system such as access to health services, cost and financing of care, and quality of services. Research topics include AIDS, health care access, primary care, rural health, medical liability, health of minority populations, long-term care, and infant mortality. Examples of studies include: AIDS Cost and Service Utilization Study (ACSUS). AHCPR nationwide survey of the use and costs of health care and social services by adults, adolescents, and children with AIDS or other HIV-related illnesses. Doctor-Patient Communications and Medical Malpractice. Four- year, $1.4 million study of how doctors' attitudes influence patient communication and related factors affecting medical malpractice suits. Health Insurance for the Low Income: An Evaluation. Six-year, $2.2 million evaluation of Washington State's Basic Health Plan of health insurance for low-income residents through managed care. National Medical Expenditure Survey. AHCPR profile and in depth analysis of where Americans as a whole and groups such as minorities, women, children, and the poor go for health care, the services they use, costs, and payment methods. Primary Care for High-Risk Indigent Infants. Five-year, $960,000 evaluation of an innovative program in Texas to reduce deaths among Hispanic, black, and other low birthweight babies after hospital discharge.