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November 19, 2002


Emory Gets Federal Award to Study Effects of Terrorism on Health Care System

ATLANTA -- Emory University's Center on Health Outcomes and Quality has been funded by the Agency for Healthcare Research and Quality (AHRQ) for $270,000 to study the effects of the 9-11 terrorism and anthrax attacks of 2001 on the health care system. The findings will be used to help the health care community understand, anticipate and better prepare for the impact of possible future terrorism.

A team from the Emory Center on Health Outcomes and Quality and the Center for Public Health Preparedness and Research, both in the Rollins School of Public Health, will study the effects of stress-aggravated or stress-related diseases on health care demands and costs.

"Terrorism brought about fear and disruption of our daily lives that left a psychological aftershock," says co-principal investigator Diane Green, PhD, MPH, Research Assistant Professor, Emory Center on Health Outcomes and Quality. "Anxiety disorders, post-traumatic stress disorder and depression may be the tip of the iceberg for health effects and demands on health systems."

Ruth Berkelman, MD, Rollins Professor and Director, Center for Public Health Preparedness and Research and co-principal investigator of the study, adds that, "Certain types of health care utilization, especially of mental health services, have probably increased since last fall, and the magnitude of the effect may depend on how close individuals were to the World Trade Center bombings and to the anthrax victims. We expect to see fewer effects further from New York and the East Coast, but some effects on mental health and other services may be nationwide.

"Immediately following a major terrorism event like 9/11," Dr. Berkelman says, "it is unclear whether people will increase or decrease visits such as those for routine care, minor illnesses or elective medical procedures."

Researchers will use health care utilization data collected from certain Aetna health plans because of Aetna’s diverse membership ­ it has members in 47 states and offers both HMO and PPO-based products. Using the ample statistical data, researchers will be able to examine multiple health outcomes and stratify analyses by location, type of product, and demographics. To determine costs to the healthcare system, utilization patterns will be studied in inpatient, outpatient and emergency department settings.

The study population will be selected using Aetna members in the areas directly affected by the terrorist events of September ­ October 2001(Washington, D.C., parts of New York, New Jersey and Florida) and a sample of the member population in several other areas based on the nine standard divisions defined by the U.S. Census Bureau.

Drs. Green and Berkelman say that although stress has been recognized as a risk factor for numerous illnesses, less is known about the clinical effects of terrorism on health care utilization for both mental health disorders such as depression and anxiety disorders as well as physical conditions such as cardiovascular disease and asthma.

"This study is a contribution to national preparedness," says Dr. Berkelman. "By understanding the impact of specific terror-related events, the health care community is better prepared to anticipate both the short- and long-term impact of future events."

In November 2001, the USQA Center for Health Care Research TM, a division of U.S. Quality Algorithms, Inc., the health informatics subsidiary of Aetna Inc., moved to Emory where it became the cornerstone of the Emory Center on Health Outcomes and Quality.

The Emory Center on Health Outcomes and Quality, a multi-school, multi-disciplinary group within The Robert W. Woodruff Health Sciences Center, was created to conduct outcomes-based research that includes assessing and improving methods for measuring quality of care and designing interventions to improve health outcomes. It works with consumers, physicians and insurers to evaluate and implement new approaches for improving quality of care.

The Emory Center for Health Outcomes and Quality is part of the AHRQ-supported Integrated Delivery System Research Network, a model of field-based research that links many of the nation's top investigators with some of its largest health systems for accelerated research on cutting-edge issues. The mission of AHRQ, the federal government's lead health services research agency, includes supporting research to improve the quality and effectiveness of health care, and to reduce medical errors and improve patient safety.

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