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AHRQ issues quality, disparities reports
The Agency for Healthcare Research and Quality (AHRQ) on April 13 released the 2009 National Healthcare Quality Report and the National Healthcare Disparities Report, which are used by a variety of health care stakeholders to evaluate quality and access to care.
Lt. Karen Ho, lead staff at AHRQ, tells Medical Ethics Advisor the findings were fairly consistent with previous years; however, since the reports have only been published since 2003, it is difficult to detect trends in the data. The reports are mandated by Congress.
"Despite promising improvements in a few area of health care, we are not achieving the more substantial strikes that are needed to address persistent gaps in quality and access," said AHRQ Director Carolyn M. Clancy, MD, in an AHRQ news release. "Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals."
For example, rates of postoperative sepsis increased by 8%. And according to the press release, although rates are improving incrementally, blacks, Hispanics, Asians, and American Indians are less likely than whites to receive preventive antibiotics before surgery in a timely manner.
According to the press release, "Americans with no insurance are much more likely than those with private insurance to obtain recommended care, especially preventive services and management for diabetes. While differences between blacks and whites in the rate of lack of insurance have narrowed in the past decade, disparities related to ethnicity, income, and education remain large."
With the passage of health care reform, Ho tells MEA that with the increased or first-time access for millions of patients to health care services, there is an expectation that the data will improve once those patients are evaluated across the system in future reports.
Hastings Fellows selected for commission
The Hastings Center reported that Hastings Center Fellows Anita Allen, Christine Grady, and Daniel Sulmasy were appointed to President Barack Obama's Commission for the Study of Bioethical Issues.
Amy Gutmann, who was appointed chair of the commission in November, is also a Hastings Center fellow.
"With her pioneering scholarship on democratic deliberation and her great experience as a leader, Amy Gutmann is a brilliant choice as chair . . .," said Thomas H. Murray, president of The Hastings Center. "Anita Allen, Christine Grady, and Dan Sulmasy are eminent bioethics scholars who will be outstanding commissioners. At a time when the promises raised by emerging biotechnology and the public policy challenges posed by health reform make bioethics more relevant than eve, I am delighted that their voices will help guide public conversation."
According to The Hastings Center, the goal of the commission "will be to identify and promote policies and practices that ensure that scientific research, health care delivery, and technological innovation are conducted in an ethically responsible manner."
Gutmann is president of the University of Pennsylvania, among other appointments. Prior to her appointment as president in 2004, she served as provost at Princeton University.
Allen is the Henry R. Silverman professor of law and professor of philosophy at the University of Pennsylvania Law School. She also serves as deputy dean for academic affairs of the school and is senior fellow in the bioethics department, School of Medicine.
Grady is the acting chief of the department of bioethics at the National Institutes of Health Clinical Center. She is also a senior research fellow at the Kennedy Institute of Ethics and was elected as a fellow at the American Academy of Nursing.
Sulmasy, A Franciscan Friar, holds the Kilbride-Clinton Chair in Medicine and Ethics in the Department of Medicine and Divinity School and is associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago.
ID gov asks legislature to revisit bill
Compassion & Choices, an advocacy group for "aid in dying" at the end of life, reported in a press release that Idaho Gov. Butch Otter, in a March 29 letter to the Idaho Senate, encouraged the legislature to revisit a particular bill.
The bill will authorize health care workers to ignore the wishes of terminally ill patients, according to Compassion & Choices.
The group hailed the governor's "concern for honoring decisions within living will and powers of attorney concerning end-of-life treatment." However, the group, in the news release, expressed disappointment that the governor allowed the legislation to become law without signing it.
According to Compassion & Choices, S 1353 could "potentially affect end-of-life care by removing the patient's own decision-making and putting the decision in the hands of health care professions, who, based on their own religious or moral beliefs, could choose or choose not to follow certain end-of-life directives determined by the patient.
In a March 24 news release, C&C President Barbara Coombs Lee said the bill would "protect doctors, nurses, and other health care workers who refuse to treat pain and suffering of a dying patient, if they believe in the redemptive power of suffering."
"If a professional's faith dictates individuals should face death while conscious, they could refuse to provide the treatment known as 'palliative sedation' . . . ," Lee said.