Introduction

Managed care organizations (MCOs) are responsible for

ensuring that persons enrolled in their plans receive quality

health care. In addition, MCOs publicly funded through the

Medicare and Medicaid programs are required by State and

Federal governments to meet certain quality standards. To

fulfill their responsibilities, MCOs need ready access to a

comprehensive array of evidence-based clinical information

and other clinical performance measures to enable them to

evaluate their providers’ performance and identify areas

where improvement is needed. They also need to know how

their members feel about the care they receive and the way

they are treated. Finally, they need to ensure that both their

providers and members are aware of the most recent

preventive care recommendations. Valid, reliable, and costeffective measurement tools must be available to make such

determinations, but these tools have not always been

available. Furthermore, because the science of

performance measurement is relatively new, additional

measures need to be developed and those that have been

developed can be improved. Therefore, to ensure that their

enrollees in MCOs receive high-quality care, MCOs need a

reliable source to provide the most current and scientifically

sound tools.

In response to this need, the Agency for Healthcare

Research and Quality (AHRQ) has funded research to

compile a database of evidence-based clinical guidelines

and to develop clinical performance measures, member

satisfaction surveys, and preventive care recommendations

that can help MCOs meet their responsibilities.

Additionally, AHRQ funds research and develops

performance measures and guidelines that MCOs, insurers,

providers, and consumers can trust.

This report describes these tools and how they have been

used and provides information on where to learn more

about them. 

AHRQ Tools for Managed Care

Making a Difference

National Guideline Clearinghouse is an online database of

clinical practice guidelines...Page 3.

Clinical performance measures allow baselines to be

created and progress to be measured...Page 3.

Q-SPAN helps develop new clinical performance measures

and improve existing ones...Page 5.

The Child Health Toolbox contains performance measures

to assess the quality of care for children...Page 5.

CAHPS® helps plans to understand consumer perspectives

on care and plan administration... Page 6.

Publications assist clinicians and consumers in practicing

preventive health care...Page 6.

Issue #11 March 2003

Author: Mark W. Stanton, M.A.

Managing Editor: Julius Patterson

Design and Production: Joel Boches

Suggested citation: Stanton MW. AHRQ Tools for Managed Care. Rockville (MD): Agency for Healthcare Research and Quality; 2003. Research in Action Issue 11.

AHRQ Pub. No. 03-0016.

RESEARCH

IN ACTION

Agency for Healthcare Research and Quality • www.ahrq.gov
Background

Around one-half of insured Americans are enrolled in some

form of managed care; however, as the number of persons

enrolled in MCOs increased in the 1990s, health care

purchasers, policymakers, and other stakeholders became

concerned about the potential for health care quality to

diminish. In their view, the policies and practices imposed

by MCOs to reduce what MCOs define as unnecessary care

might result in patients not receiving needed care.

Therefore, MCOs faced accreditation systems and other

requirements to ensure that patients were receiving the most

appropriate care. More recently, MCOs have had to address

other emerging concerns such as the rapid introduction of

new technologies, data showing unexplained variations in

the provision of care, and severe cost pressures. These

factors have provided additional motivation to MCOs to

develop systematic ways of preserving and enhancing

health care quality and cost-effectiveness. 

Evidence-based practice guidelines and performance

measures were developed to help ensure that patients

always receive the most appropriate care. These guidelines

and measures are based on thorough reviews of the relevant

medical and health services research as well as on the

collection and analysis of detailed data about the clinical

and administrative aspects of care. 

By using systematic, valid, and reliable methods for

providing quality care, measuring the extent of their success

and reporting the results, MCOs are able to demonstrate to

policymakers as well as institutional and individual health

care purchasers the extent to which the care furnished to its

members has been maintained and improved. They can also

use those results to assist in internal quality improvement

programs, viewed by managed care professionals as an

integral part of their responsibilities. Furthermore,

individual and corporate purchasers of health care also view

quality improvement as essential because they are seeking

the best care that they can afford to buy, and they believe

that high-quality care could cost them less because they are

not paying to correct mistakes. Purchasers, in particular,

believe that improved health care leads to healthier and

more productive employees. Also, as health care evolves

toward a more patient-centered model that considers

consumer and patient preferences, MCOs need to learn

more about patients’ perspectives on various aspects of their

care. 

AHRQ-funded tools 

To meet the multiple challenges facing MCOs in the 21st

century, AHRQ-funded researchers have developed, tested,

and helped to implement a sophisticated array of tools. 

These tools include: 

• The National Guideline ClearinghouseTM (NGC)—an

online database of clinical practice guidelines.

• National Quality Measures ClearinghouseTM (NQMC)—

an Internet-based resource of evidence-based health care

quality measures.

• Patient Outcome Research Teams (PORTS)—clinical

performance measures, including those for heart attack

treatment and diabetes care.

• Q-SPAN—expanded quality of care measures, including

a screening measure for chlamydia. 

• Child Health Toolbox—a listing of measures

specifically intended to be used to measure the quality

of care provided to children.

• Consumer Assessment of Health Plans (CAHPS®)—

patient satisfaction surveys on health plans and health

care.

• U.S. Preventive Services Task Force (USPSTF)—an

independent panel of private-sector experts in primary

care and prevention. The Put Prevention Into Practice

Program (PPIP) implements USPSTF recommendations

by issuing a series of consumer-oriented publications on

various aspects of preventive care.

Although many of these AHRQ-funded tools have been

developed in managed care settings, they are applicable to

other settings as well. 

2 www.ahrq.gov

Links to AHRQ Tools on the Internet

NGC http://www.guideline.gov

NQMC http://www.qualitymeasures.ahrq.gov

Q-SPAN http://www.ahrq.gov/qual/qspanovr.htm

Child Health Toolbox http://www.ahrq.gov/chtoolbx/

CAHPS® http://www.ahrq.gov/qual/cahpsix.htm

USPSTF http://www.ahrq.gov/clinic/ppipix.htm
The National Guideline ClearinghouseTM acts as a

comprehensive database of clinical practice

guidelines 

Before MCOs can evaluate whether patients are receiving

the right care at the right time, they must identify

acceptable practices. The NGC is a comprehensive

database of evidence-based clinical practice guidelines and

related documents produced by AHRQ in partnership with

the American Medical Association (AMA) and the

American Association of Health Plans (AAHP).1

Cosponsorship by the major national trade association

representing managed care plans is a clear indication of the

value of these guidelines in achieving the quality goals of

managed care. The NGC provides health plans, health care

providers, integrated delivery systems, purchasers, and

others user-friendly access to objective, detailed

information on clinical practice guidelines and to further

their dissemination, implementation, and use. As of

December 2002, the Clearinghouse included 917 guidelines

on diseases and conditions, 648 guidelines on analytical,

diagnostic, and therapeutic techniques and equipment, 377

guidelines on chemicals and drugs, and 111 guidelines on

behavioral disciplines and activities.

Key components of NGC include: 

• Structured abstracts (summaries) about the guideline

and its development. 

• Ability to compare attributes of two or more guidelines

side-by-side. 

• Syntheses of guidelines that cover similar topics,

highlighting areas of similarity and difference.

• Links to full-text guidelines, where available, and/or

ordering information for print copies.

• An electronic forum, NGC-L, for exchanging

information on clinical practice guidelines, their

development, implementation, and use. 

• Annotated bibliographies on guideline development

methodology, implementation, and use. 

The National Quality Measures Clearinghouse

replaces CONQUEST 

AHRQ recognized the essential link between clinical

practice guidelines, quality measures, and the need of

MCOs and others to find efficient and reliable methods for

measuring quality health care. Therefore, in 1998, AHRQ

initiated a 4-year project to develop the NQMC, a Webbased resource of evidence-based health care quality

measures. AHRQ’s purpose in establishing the NQMC is to

promote widespread access to quality measures by MCOs

and other members of the health care community.2 The

NQMC, available in February 2003 and replacing

CONQUEST, is designed to be a database for information

on specific health care quality measures and measure sets.

Quality measure summaries will be retrievable by many

parameters including topic, target population, and setting of

care. Users of NQMC will be able to search the NQMC

and the NGC simultaneously. 

Patient Outcome Research Teams provided basis for

development of clinical performance measures

To accurately gauge whether providers within an MCO are

providing quality care, the performance measures and

clinical guidelines used should be based on scientifically

www.ahrq.gov 3

Impact of NGC

Over the last two years, the NGC has had over 2 million visitors, processed over 23 million requests, and received over 42

million hits.

Here is what some people are saying about NGC:

“[The NGC] provides a valuable framework from which to continue our guideline development or renewal process.

Because of their credibility, MDs buy into these guidelines as accepted standards of care. Therefore more effort can be

given to implementation and compliance monitoring of the guidelines. Since the guidelines are updated as necessary, we

don’t have to pull teams of MDs together for multiple sessions to consider relevant modifications.”

“Downloading guidelines [from the NGC] and adapting them to our local Swiss health care environment is essential for us,

an HMO, to provide managed care; in addition we profit from work done in a much bigger country such as the U.S. It

makes me stop and consider if I have current evidence for my practice.”
proven treatments. From 1989 to 1997, AHRQ sponsored a

series of 14 research projects designed to answer critical

questions about the medical and cost effectiveness of

available treatments for common clinical conditions such as

acute myocardial infarction, diabetes, prostate disease,

cataract, and low birthweight.3 The PORT findings led to

the development of performance measures that can

determine whether patients receive appropriate care. 

The PORTs consisted of multidisciplinary teams of

researchers ranging from health economists and clinicians

to quality-of-life experts and epidemiologists. PORT

investigators were instructed to answer questions about

what treatments work, at what cost, and why variation

exists in the use of treatments. The PORT projects

represented an essential start to defining and refining the

methods for producing outcomes and effectiveness

measures. 

Performance measure for beta-blocker treatment after a

heart attack helps improve care of heart patients

One result of the PORT reviewing cardiac conditions was

the development of a measure to determine whether

patients received beta-blockers when appropriate. Betablockers are drugs that help prevent heart attacks by acting

to stabilize the heart. A 1997 study of elderly Medicare

patients reported that the mortality rate among those that

received beta-blockers was 43 percent lower than among

those who did not. Although research has shown that betablockers substantially improve survival in elderly people

who have had a heart attack, AHRQ researchers found that

only one of five patients received them, thus doubling their

risk of death. Furthermore, beta-blocker recipients were

rehospitalized 22 percent less often than nonrecipients.

Also, treatment with beta-blockers after a person suffers a

heart attack reduces the chance of a subsequent attack

between 20 and 30 percent.5

Comprehensive diabetes control measures help to

improve care of diabetes patients

AHRQ’s PORT on diabetes care developed a

comprehensive, prospective, longitudinal database that

addressed costs, quality, and outcomes of care for patients

with Type II diabetes. It assessed the value of specific

known interventions, such as preventive eye care, and

tested the usefulness of new tools for disease management.

Performance measures developed as part of this PORT have

been used as indicators or tools to assess the level of care

provided within systems of care to patients with diabetes. 

For example, in 1998, the Diabetes Quality Improvement

Project (DQIP), a coalition of public and private entities,

developed the initial set of diabetes-specific performance

and outcome measures.6 These measures replace a number

of conflicting standards and are being used by MCOs,

4 www.ahrq.gov

Performance measure for beta-blocker treatment after a heart attack is being used by managed care organizations

and accrediting bodies

Since 1996, the National Committee for Quality Assurance (NCQA), the organization that accredits health plans, has included a measure for

prescribing beta-blockers in the Health Plan Employer Data Information Set (HEDIS®). HEDIS® is a set of standardized performance measures

that allows a managed care plan to measure its performance and compare it to that of other managed health care plans. The HEDIS® Beta

Blocker Treatment after a Heart Attack measure estimates the percentage of members aged 35 years and older who were hospitalized and

discharged from the hospital after surviving a heart attack (defined as an acute myocardial infarction [AMI]), and received a prescription for a

beta blocker.

Health plans are using the beta-blocker indicator in their public reports to NCQA, employers, States, and others. These reports provide annual

updates on a broad range of clinical performance and consumer satisfaction measures. Furthermore, as required by NCQA accreditation

standards, plans are using the indicator as part of their efforts to improve quality. The latest NCQA report on managed care quality reported

that the average HEDIS®-participating managed care plan increased its beta blocker treatment percentage from 87 percent in 1999 to 92

percent in 2000. The five-point increase means that over 2,000 additional people received beta-blocker treatment in 2000, reducing their risk

of subsequent heart attack. 4

UnitedHealthcare, which represents 7 million commercial members, 430,000 Medicare members, and 500,000 Medicaid members, has made

information on the use of beta-blockers a part of its physician education program. Programs such as these have probably been partly
www.ahrq.gov 5

professionals, and health insurance purchasers to compare

diabetes care within and across health care settings. In

formulating these measures, DQIP members reviewed the

literature on clinical effectiveness along with data collected

for quality-of-care studies for patients with diabetes. This

material, including published and unpublished data from

AHRQ’s Diabetes PORT, was used as part of the evidence

base that guided DQIP’s decisionmaking. 

Health plans, health care professionals, purchasers of health

care, and consumers are gradually making greater use of

the DQIP measures, which focus on blood sugar (Hb A1c)

testing, eye and foot exams, blood pressure control, and

monitoring for kidney disease. According to NCQA,

diabetic members of managed care plans reported increases

in blood sugar testing, kidney disease screening rates, and

eye exam rates between 1999 and 2000 (Table 1). 

Q-SPAN further strengthens existing performance

measures and develops new ones

MCOs are looking continually for new or better measures

that will assist them in their quality assurance and quality

improvement efforts. As a result of this and other factors,

AHRQ is constantly working on strengthening the scientific

basis of quality measurement while expanding the scope

and availability of validated, ready-to-use measures. 

Q-SPAN is an AHRQ-funded project involving Harvard,

RAND, and NCQA that focuses on the expansion of

quality-of-care measures.7 It builds on past work in

quality measurement by public and private organizations

through cooperative agreements to develop and test

additional clinical performance measures for specific

conditions, patient populations, and health care settings. In

addition, once the new measures are ready for use, they will

be added to the more than 1,200 performance measures

included in the NQMC. 

An example of a clinical performance measure developed

by the Q-SPAN project is the chlamydia screening measure.

Chlamydia is the most common sexually transmitted

disease, with an estimated 3 million cases annually.8 The

chlamydia measure assesses the proportion of sexually

active women between the ages of 15 and 25 who received

a screening test for chlamydia within the past year.

Screening for chlamydia is especially important because 60

to 70 percent of women with chlamydia do not experience

any symptoms. Consequences of the disease can be serious,

often including pelvic inflammatory disease, heightened

risk of ectopic pregnancy (development of the fertilized egg

outside of the uterus) or even infertility. Fortunately,

therapies are inexpensive and offer cure rates approaching

100 percent.9

Other clinical performance measures being designed by 

Q-SPAN include those related to asthma, cardiovascular

disease, hip fractures, subacute and home care programs,

and dental care plans.

Child Health Toolbox

Because children’s health care needs differ from those of

adults, AHRQ has collected various measurement sets to

help MCOs and others assess the performance of child

health programs. These measurement tools have been put

Table 1. Clinical Performance Measures for

Diabetes Care Track Improvements

1999 2000

Blood sugar testing 75% 78%

Eye tests 45% 48%

Kidney disease screening 36% 41%

Source: National Committee for Quality Assurance. The State of Managed Care

Quality 2001

Use of Chlamydia Measure

• NCQA has included the screening measure in its HEDIS®

2000. The measure is collected separately for women

aged 16 to 20 years and those aged 21 to 26 years.

These two age groups account for 79 percent of all

incidences of chlamydia infection in women in the U.S.6

• Only a minority (22 percent) of female health plan

members aged 16 to 20 years received chlamydia

screening in 2000. Chlamydia screening was not

widespread in 2000, but the percentage of eligible 16-

to 20-year-olds that received the screening increased

five points between 1999 and 2000, from 17 percent in

1999 to 22 percent in 2000. Screening in women aged

21 to 26 years increased four points, from 15 percent in

1999 to 19 percent in 2000.
into AHRQ’s Child Health Toolbox, which can be accessed

on the Agency’s Web site.10 This online resource can help

MCOs, policymakers, and others develop plans that

reliably measure health care performance in child health

programs such as whether children are receiving quality

health care and whether a health program is functioning

effectively. Specifically, this Web site has links to tools

and information on how to measure performance, access,

quality, and health service delivery, as well as concepts,

tips, and tools for evaluating health care service programs

for children. Information about how to develop

performance guidelines can also be found at this site.

Consumer Assessment Surveys (CAHPS®) provide

valuable information about consumer perspectives

For health plans to improve the quality of their services, it

is important for them to assess their members’ experiences

with the health care they receive. CAHPS® (formerly the

Consumer Assessment of Health Plans) is an easy-to-use

kit of survey and report tools that provides reliable and

valid information on consumer perspectives on their health

plans and health care.11 The kit contains a set of

questionnaires that ask consumers about their experience

with their health plans, sample formats for reporting

results to consumers, and a handbook to help implement

the surveys and produce the reports.

Consumers are asked about whether they received the care

they needed in a timely manner, the quality and

promptness of their care, the quality of provider

communication, courtesy and helpfulness of office staff,

and quality of the customer service. They are also asked

to rate their physicians, health care, and health plan.

By providing the consumers’ view of the quality of care

and services they experience with their health plans,

CAHPS® offers to health plans useful information that

assists MCOs with quality monitoring and improvement. 

The U.S. Preventive Services Task Force and Putting

Prevention into Practice offer MCOs tools to

measure their goals 

One of MCOs stated goals is to foster preventive health

care practices among their providers and enrollees. A

panel managed by AHRQ is assisting MCOs and other

sectors of the health care system by providing updated

comprehensive preventive care recommendations. Using

these recommendations, MCOs can evaluate whether their

providers are delivering appropriate services.

The U.S. Preventive Services Task Force (USPSTF), an

independent panel of private-sector experts in primary care

and prevention, managed since 1998 by AHRQ,

systematically reviews the evidence on the effectiveness of

clinical preventive services. These include screening tests,

counseling, and immunizations.12 The mission of the Task

Force is to evaluate the benefits of individual services, to

create age-, gender-, and risk-based recommendations

about services that should routinely be incorporated into

primary medical care and to identify a research agenda for

clinical preventive care. AHRQ’s Put Prevention Into

Practice (PPIP) program works to implement Task Force

recommendations and to increase the appropriate use of

clinical preventive services through a variety of resources

and tools for clinicians, health care systems, patients, and

the public.13

USPSTF recommendations have been used by numerous

health plans and have been endorsed by AAHP, as a guide

to what services should be regularly delivered to MCO

members. The recommendations also have been used by

major primary care specialty organizations, including the

American Association of Family Practice, the American

College of Physicians, and the American Society of

Internal Medicine, as a basis for their prevention

guidelines. Finally, Task Force assessments of the

6 www.ahrq.gov

Impact of CAHPS®

CAHPS® is being used currently by the NCQA in the Health Plan

Employer Data Information Set (HEDIS®) and is required for

health plan accreditation. By reporting important information

from the patients’ perspective, CAHPS® complements the clinical

performance measures in HEDIS®. 

The Centers for Medicare & Medicaid Services (CMS) is using a

specially developed version of CAHPS® to survey 130,000

Medicare enrollees in managed care plans. The results of the

Medicare survey were released in February 1999 to aid CMS’ 39

million beneficiaries who were selecting a health plan.

Many health plans, including Mercy Health Plan, Harvard Pilgrim

Health Care, and Health Plus of Michigan, conduct CAHPS for

commercial, Medicare, and/or Medicaid populations and use the

results for quality improvement initiatives.

In 1997 and 1998, the UnitedHealthcare Corporation (UHC)

surveyed Medicaid plans and Medicare plans not being surveyed

by CMS. The data were used by the health plans to report their

performance to State and Federal regulators. 
www.ahrq.gov 7

evidence supporting individual services are often used in

the development of HEDIS® measures. Through the

USPSTF Web site (www.preventiveservices.ahrq.gov),

users can access USPSTF recommendations, age- and sexspecific tables about recommended preventive services, and

reports describing in detail the evidence considered by the

USPSTF for each service. In addition, PPIP develops

additional materials to translate and disseminate the work

of the USPSTF for both clinicians and patients.

Publications emanating from this program include The

Clinician’s Handbook, Personal Health Guide, Child

Health Guide, and Staying Healthy at 50+. The Clinician’s

Handbook contains summaries of recommendations on

screening tests, immunizations, and counseling for

children/adolescents and adults/older adults by major

authorities, including the USPSTF.14 The Personal Health

Guide helps patients make sure that they get needed tests,

immunizations (shots), and guidance to stay healthy.15 The

Child Health Guide helps parents to work with the doctor,

nurse, or other health care provider to keep their children

well.16 The Staying Healthy at 50+ guide describes ways

that people aged 50 and older can stay healthy.17 It gives

information on screening tests, immunizations, and living

habits that have been proven to help prevent certain

diseases and conditions. 

Conclusion

AHRQ has supported the development of tools such as a

clearinghouse for clinical practice guidelines, clinical

performance measures, consumer satisfaction surveys, and

information about preventive care that is being used by

MCOs to make decisions and improve the quality of health

care. Because these scientifically valid and reliable tools

are available, policymakers, corporate, and individual health

insurance purchasers, providers, and MCOs themselves are

able to use these tools to help their patients. 

For more information

This synthesis was written by Mark W. Stanton

(mstanton@ahrq.gov). For further information on the

following AHRQ tools, contact: 

National Guideline Clearinghouse

Jean Slutsky

info@qualitymeasures.ahrq.gov

National Quality Measures Clearinghouse

Jean Slutsky

info@qualitymeasures.ahrq.gov

Patient Outcomes Research Teams

AHRQ (main number)

301-594-6662

Q-SPAN

Judy Sangl

301-594-1702

Child Health Toolbox

Denise Dougherty, Ph.D.

301-594-2051

CAHPS®

Christine Crofton

301-594-2003

U.S. Preventive Services Task Force

Kenneth S. Fink, M.D.

301-594-1487

Put Prevention Into Practice

Hazel K. Keimowitz

301-594-6393

Impact of USPSTF/PPIP Publications

Since 1998, AHRQ has received numerous requests for

bulk shipments of PPIP publications.

Requests for these publications have come from managed

care organizations as well as associations; businesses;

Federal, State, and local governments; hospitals; and

universities, all of which have found important uses for the

materials. For example, health plans have distributed The

Clinician’s Handbook to their primary care providers and

the health guides to their patients. 

The following managed care organizations have requested

such materials: Cigna Healthcare of Tempe, AZ; Evanston

Northwestern Healthcare of Skokie, IL; UCARE Minnesota

of St. Paul, MN; UTMB Healthcare Systems of Houston,

TX; and Valley Health Systems, Inc. of Huntington, WV.

References

1. The National Guideline ClearinghouseTM. Fact Sheet.

AHRQ Publication No. 00-0047, July 2000. Agency for

Healthcare Research and Quality, Rockville (MD); Web

site: http://www.ahrq.gov/clinic/ngcfact.htm.

2. Measures Sought for National Quality Measures

ClearinghouseTM. August 2002. Agency for Healthcare

Research and Quality, Rockville, MD. Web site:

http://www.ahrq.gov/qual/nqmcmeas.htm.

3. Freund D, Lave J, Clancy C, et al. Patient outcomes

research teams: contribution to outcomes and

effectiveness research. Ann Rev of Pub Health 1999,

20:337-59. Reprints (AHCPR Publication No. 99-R073).

4. National Committee for Quality Assurance. The State of

Managed Care Quality 2001. Standard version. Web

site: <http://www.ncqa.org/somc2001/>.

5. Soumerai SB, McLaughlin TJ, Spielgelman D, et al.

Adverse outcomes of underuse of beta-blockers in

elderly survivors of acute myocardial infarction. JAMA

1997; 277(2): 115-21.

6. Diabetes Quality Improvement Project. DQIP

Background. Web site:

http://www.dqip.org/background.html. Accessed on

January 13, 2003. 

7. Expansion of Quality Measures (Q-SPAN). Agency for

Health Care Policy and Research, Rockville (MD).

January 12, 1998. Web site:

http://www.ahrq.gov/qual/qspanovr.htm.

8. Centers for Disease Control and Prevention. Chlamydia

in the United States. April 2001. Web site:

http://www.cdc.gov/nchstp/dstd/Fact_Sheets/chlamydia_f

acts.htm Accessed on January 9, 2003. 

9. Mangione-Smith R, McGlynn E, Hiatt L. Screening for

chlamydia in adolescents and young women. Arch

Pediatr Adoles Med 2000;154:1108-13.

10. AHRQ. Child Health Toolbox. Web site:<

http://www.ahrq.gov/chtoolbx/ >. Accessed on January

9, 2003.

11. Consumer Assessment of Health Plans (CAHPS®) Fact

Sheet. AHRQ Publication No. 00-P047, April 2000.

Agency for Healthcare Research and Quality, Rockville

(MD); Web site. http://www.ahrq.gov/qual/cahpfact.htm.

12. About USPSTF. U.S. Preventive Services Task Force,

February 2002. Agency for Healthcare Research and

Quality, Rockville, MD. Web site:

http://www.ahrq.gov/clinic/uspstfab.htm.

13. About PPIP. Put Prevention Into Practice, May 2000.

Agency for Healthcare Research and Quality, Rockville,

MD. Web site: http://www.ahrq.gov/ppip/ppipabou.htm.

14. Clinical Handbook of Preventive Services, 2nd Edition,

1998. Washington, DC; U.S. Department of Health and

Human Services. Web site:

http://www.ahrq.gov/clinic/ppiphand.htm. 

15. Personal Health Guide: Put Prevention into Practice.

Consumer Information, April 1998. Publication No.

APPIP 98-0027. Agency for Health Care Policy and

Research, Rockville, MD. Web site:

http://www.ahrq.gov/ppip/ppadult.htm.

16. Child Health Guide: Put Prevention into Practice.

Consumer Information. Publication No. APPIP 98-0026,

revised July 2000. Agency for Health Care Policy and

Research, Rockville, MD. Web site:

http://www.ahrq.gov/ppip/ppchild.htm. 

17. Staying Healthy at 50+. Publication No. AHRQ 00-

0002, January 2000. Web site:

http://www.ahrq.gov/ppip/50plus.

9 www.ahrq.gov

www.ahrq.gov 11

Previous issues of Research in Action are available for free from the AHRQ Publications Clearinghouse: 1-800-358-9295.

Please specify the AHRQ publication number when you call.

Issue Title Publication Number

10 AHRQ Tools and Resources for Better Health Care AHRQ 03-0008

9 Reducing Costs in the Health Care System: Learing From 

What Has Been Done AHRQ 02-0046

8 Prescription Drug Therapies: Reducing Costs and Improving AHRQ 02-0045

Outcomes

7 Improving Treatment Decisions for Patients with Community- AHRQ 02-0033

Acquired Pneumonia

6 Medical Informatics for Better and Safer Health Care AHRQ 02-0031

5 Expanding Patient-Centered Care to Empower Patients and AHRQ 02-0024

Assist Providers

4 Managing Osteoarthritis: Helping the Elderly Maintain Function AHRQ 02-0023

and Mobility

3 Preventing Disability in the Elderly With Chronic Disease AHRQ 02-0018

2 Improving Care for Diabetes Patients Through Intensive AHRQ 02-0005

Therapy and a Team Approach

1 Reducing and Preventing Adverse Drug Events To Decrease AHRQ 01-0020

Hospital Costs
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