OUTCOMES RESEARCH: Academic Medicine and Managed Care Forum Awards Three Grants to Emory

Is it worth the effort? Do treatment benefits outweigh costs?

Researchers at the Robert W. Woodruff Health Sciences Center of Emory University have been awarded more than $850,000 to apply these questions and others to a number of aspects of health care delivery.

The support comes from the Quality Care Research Fund of the Aetna Foundation via Emory's participation in the Academic Medicine and Managed Care Forum. The forum, launched by Aetna U.S. Healthcare in 1996, brings together academic medical institutions, managed care payers, pharmaceutical companies, government agencies and others involved in the growing field of outcomes research.

IMPROVING EFFICIENCY OF ELECTIVE SURGERY

David J. Ballard, M.D., Ph.D., director of Emory's Center for Clinical Evaluation Sciences, and Charles B. Cangialose, Ph.D., assistant professor in the center, received $359,978 from the Aetna Foundation for a demonstration project that will evaluate the effect of an administrative decision support system on cost and quality of in-hospital surgical care.

The randomized trial will be conducted at Emory Hospitals in conjunction with William Bornstein, M.D., Ph.D., director of clinical development in EMORY HEALTHCARE's section of information systems, and chief quality officer and associate administrator at Crawford Long Hospital; and Katie Smith, director of Operations Planning and Improvement for Emory Hospitals.

The team will measure the effect of feedback of estimated and actual daily hospital cost generated by widely used decision support software on surgical team practice patterns, in-hospital length of stay and cost, patient satisfaction and health-related quality of life for elective procedures. The results of the analysis will ultimately clarify the value of feedback of cost information derived from this commonly used system.

CARE OF CONGESTIVE HEART FAILURE

Kimberly J. Rask, M.D., Ph.D., associate director of Emory's Center for Clinical Evaluation Sciences and assistant professor of medicine (general medicine), received $359,102 from SmithKline Beecham to fund a randomized trial of patient education versus nurse case management for patients with mild to moderate congestive heart failure.

Her Emory collaborators include cardiologist Andrew L. Smith, M.D., director, Center for Heart Failure, Emory Hospitals, and Sandra Dunbar, Ph.D., professor of adult and elder health at the Nell Hodgson Woodruff School of Nursing of Emory University.

In this randomized study, researchers will examine whether case management intervention comprised of education plus ongoing nurse case management improves quality of care, patient satisfaction, patient knowledge, health-related quality of life and reduces resource utilization and direct medical costs. These results will be compared with a program which uses an educational intervention alone.

COMMUNITY-ACQUIRED PNEUMONIA

Victor Lampasona, Pharm. D., director of the Clinical Pharmaceutical Research Program for EMORY HEALTHCARE, received $149,456 from Hoechst Marion Roussel to evaluate costs of treatment failure in community-acquired pneumonia.

In collaboration with Emory colleagues Jeff Etchason, M.D., and Dr. Cangialose, Dr. Lampasona will model different types of treatment failure and attempt to identify populations most at risk for failure of treatment.

Dr. Etchason is assistant professor of medicine at the Emory University School of Medicine and director of Health Services Research and Development at the Atlanta Veterans Affairs Medical Center.

The research team will also calculate costs associated with failures for at-risk populations, and develop a simulation model to predict the costs of treatment failure in this population.

The Aetna Foundation, Aetna U.S. Healthcare, Hoechst Marion Roussel, Merck, Schering-Plough and SmithKline Beecham announced in November 1998

their pledges of $6.8 million in funding for 20 outcomes research grants at 13 academic medical institutions participating in the Academic Medicine and Managed Care Forum. Funds were made available through the Quality Care Research Fund, to which Aetna has pledged $15 million in grants over a 5-year period, and through the pharmaceutical companies.