|
 |
National Center for
Infectious Diseases
| Title of Project |
Impact of Emerging Infectious Diseases
on Health Outcomes of Children and their Families (1) |
| Category |
Surveillance |
| Objectives and Descriptions: |
For this project, a sample of families enrolled
in a single pediatric practice accepting various types of reimbursement will be followed
longitudinally over 24 months with periodic telephone interviews and medical records
reviews. The objectives are to: (1) quantify utilization of outpatient health-care
services per family unit and assess differences in utilization patterns among persons
receiving care in different settings; (2) identify factors associated with variations in
demand and receipt of health services including--colonization or infection with
antimicrobial resistant microorganisms, type of health-care coverage, and demographic and
socioeconomic variables; (3) quantify the economic impact of illness and assess variations
in that impact and their association with different types of health-care coverage; and (4)
assess the effectiveness in different health plans of various interventions intended to
reduce the inappropriate use of outpatient antibiotics. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Center for Pediatric Research, Children's
Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, VA
Douglas K. Mitchell, MD (804) 668-6400 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$150,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
Children |
| Published Abstracts/Articles |
Mitchell DK, et al. Risk Factors for Carriage
of Trimethoprim-Resistant Escherichia coli in Stool Specimens From Young Children. IDSA
1997. Holmes SJ, et al. Colonization of
Young Children and Family Members with Penicillin-Resistant S. pneumoniae. PIDS 1998. And
Practices Towards Health-Care Utilization for Young Children. SPR, 1998.
Ramsey AF, et al. Utilization of Health Care for
Infectious Illnesses at a Pediatric Practice. SPR, 1998. |
| Title of Project |
Impact of Emerging Infectious Diseases
on Health Outcomes of Children and their Families (2) |
| Category |
Surveillance |
| Objectives and Descriptions: |
For this project, a sample of families enrolled
in each of three different health plans (a point-of-service HMO, and IPA model HMO, and
Medicaid fee-for-service health plan in transition to Medicaid managed care) will be
followed longitudinally over 24 months with periodic telephone interviews and medical
records reviews. The objectives are to: (1) quantify utilization of outpatient health
services per family unit and assess differences in utilization patterns among persons
receiving care in different settings; (2) identify factors associated with variations in
demand and receipt of health services including--colonization or infection with
antimicrobial resistant microorganisms, type of health-care coverage, and demographic and
socioeconomic variables: (3) quantify the economic impact of illness and assess variations
in that impact and their association with different types of health-care coverage; and (4)
assess the effectiveness in different health plans of various interventions intended to
reduce the inappropriate use of outpatient antibiotics. |
| Outcomes: |
|
| External Institution/Principal Investigator |
University of South Carolina School of Public
Health
Leiyu Shi, DrPH, MBA, MPA (410) 614-2062 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$150,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
Children |
| Published Abstracts/Articles |
|
| Title of Project |
Use of Integrated Health Information
Systems for Post-Discharge Surveillance of Surgical Site Infections |
| Category |
Information Systems |
| Objectives and Descriptions: |
The objectives of this pilot project are to:
(1) develop a method, in a mixed model managed care organization (MCO), of comparing
traditional in-hospital and post-discharge surveillance to the utilization of automated
claims, pharmacy, and other data for the detection of surgical site infections; and (2)
initiate a demonstration project whereby the automated MCO-based surveillance methodology
becomes operational as a clinical performance measure. |
| Outcomes: |
|
| Contractor/Project Manager |
American Association of Health Plans
Barbara Lardy, MPH (202) 778-3229 |
| Subcontractor/Principal
Investigator |
Harvard Community Health Care
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Teresa Horan (404) 639-6439 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1997: $57,000 FY 1998: $39,996 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Methods of Inpatient Surveillance for
Surgical Site Infections. |
| Category |
Surveillance |
| Objectives and Descriptions: |
This project will compare the accuracy and
resource requirements of the National Nosocomial Infection Surveillance (NNIS), ICD-9
diagnosis codes, and quantitative antibiotic exposure thresholds to identify surgical site
infections after CABG, breast surgery, and Cesarean delivery. A full cohort design will be
used to compare NNIS surveillance to ICD-9 discharge diagnosis codes, as well as to assess
the relationships between: (1) quantitative antibiotic exposure and NNIS surveillance and
(2) quantitative antibiotic exposure and ICD-9 codes. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$90,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Methods of Outpatient Surveillance for
Surgical Site Infections. |
| Category |
Surveillance |
| Objectives and Descriptions: |
A majority of surgical site infections occur
after hospital discharge. Analysis of automated claims and pharmacy data typically
available to managed care organizations (MCOs) and insurers should identify greater
numbers of such infections than questionnaires to patients or surgeons. In this study, a
cohort of patients receiving 6,000 surgical procedures in 10 hospitals will be
prospectively monitored for surgical site infections using automated data. Anticipated
results include the refinement of decision algorithms and an assessment of the
generalizability of this method to other institutions and managed care organizations. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural: |
$90,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Epidemiology of Post-Discharge
Infections Associated with Implanted Central Venous Catheters |
| Category |
Research |
| Objectives and Descriptions: |
The objectives of this project are to: (1)
determine the feasibility, in a managed care environment, of using existing electronic
data to identify individuals with long-term intravascular catheterization, the duration of
catheterization, and any associated complications; (2) design an automated records-based
system which will identify complications associated with long-term catheterization and
determine the performance characteristics of that system; (3) describe the use of
long-term intravascular catheterization in the study population and the epidemiology of
catheter-associated complications; and (4) quantify the consequences of
catheter-associated complications. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$60,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Epidemiology of Post-Discharge Neonatal
Infections |
| Category |
Research |
| Objectives and Descriptions: |
The specific aims of this project are to: (1)
develop methods for using automated medical records to identify neonatal infections; (2)
describe the epidemiology of postnatal infections for a defined population of infants
using automated full text records, pharmacy data, and claims data; and (3) assess the
impact of various neonatal and maternal exposures on neonatal infections. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding through 1998: |
$50,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Use of HMO Administrative and Pharmacy
Data for Surveillance of Health-Care Associated Infections |
| Category |
Surveillance |
| Objectives and Descriptions: |
This project will: (1) compare traditional
hospital-based surveillance to MCO-based automated surveillance for all general surgery
procedures from three MCOs, expanding the scope of an earlier project (Use of Integrated
Health Information Systems for Post-Discharge Surveillance of Surgical Site Infections);
and (2) initiate a demonstration project whereby the automated MCO-based surveillance
methodology becomes operational as a clinical performance. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding through 1998: |
FY 1998: $125,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project: |
Peri-Operative Antimicrobial
Prophylaxis and Resistant Clinical Isolates |
| Category |
Prevention Effectiveness |
| Objectives and Descriptions: |
The rapid rise in antimicrobial resistance
represents a major public health threat. Inappropriate antimicrobial use (e.g., prolonged
peri-operative antimicrobial prophylaxis) is believed to be an important contributor. This
project will determine the rate of post-operative infection or clinically recognized
colonization due to resistant Gram-negative and Gram-positive organisms in a prospectively
monitored cohort of patients undergoing 6,000 surgical procedures in a managed care
environment. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Prevention Epicenter of Eastern Massachusetts
Richard Platt, MD, MSc (617) 421-6859 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
$30,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Management of Vancomycin-Resistant
Enterococcal Colonization during Outpatient Care and Readmission of Cancer Patients. |
| Category |
Prevention Effectiveness |
| Objectives and Descriptions: |
This project will seek ways to assure that: (1)
patients readmitted to the hospital with vancomycin resistant enterococcal (VRE)
infection/colonization are appropriately placed on isolation; and (2) fewer patients
requiring readmission will need to be placed on isolation by coordinating outpatient
visits to minimize the potential spread of VRE infection/colonization in that setting.
Methods will include patient education on the need for specimen collection, staff
education on the need for confirmation of infection status and improved coordination with
admitting data systems and personnel. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Memorial Sloan Kettering Cancer Center
Kent Sepkowitz, MD (212) 639-2441 |
| CDC Project Officer |
Michele L. Pearson, MD (404) 639-6415 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural: |
$50,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
Immune compromised patients |
| Published Abstracts/Articles |
|
| Title of Project |
Long Term Clinical and Economic Impact
of Health-Care Associated Infections |
| Category |
Research |
| Objectives and Descriptions: |
Often, patients with health-care associated
infections suffer from reduced functional status; making them likely to have higher costs
of care in an integrated delivery system. This project will assess the functional status
of patients for up to one year after health-care associated infections. Patients enrolled
within 72 hours of the diagnosis of infection will have repeat assessments at 1, 3, and 6
months after diagnosis. Estimated pre-morbid functional status will be established through
patient and family interviews. Controls will be matched for age (±5 years), recent
surgical procedures (past month), and primary reason for admission and diagnosis. At the
end of the project period, the functional status and overall cost of care for the study
and control groups will be compared. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Johns Hopkins University School of
MedicineUniversity of Maryland and Maryland V.A. Health System
Trish M. Perl, MD, MSc (410) 955-8384
|
| CDC Project Officer |
Ralph L. Cordell, PhD (404) 639-6478 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1997: $105,000 FY 1998: $105,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Reengineering Infection Control
Programs in Integrated Delivery Systems and Networks |
| Category |
Capacity Building |
| Objectives and Descriptions: |
This project aims to improve the efficiency of
infection control programs across the continuum of care by: (1) developing and expanding
the use of electronic surveillance, (2) working closely with pharmacy programs to improve
antibiotic utilization, and (3) developing and implementing infection control programs for
outpatient and long term care facilities which are linked with acute care infection
control programs. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Washington University School of Medicine
Victoria Fraser, MD (314) 454-8272 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
None |
| Annual Extramural Funding |
$30,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
Murphy D, et al. Redesigning the Business of
Infection Control for the 21st Century. APIC 1998. |
| Title of Project |
Epidemiology and Resistance of
Pathogens Causing Urinary Tract Infection |
| Category |
Research |
| Objectives and Descriptions: |
This project will focus on the epidemiology of
urinary tract infections (UTI) in an ambulatory patient population residing in a large
urban area where multiresistant urinary tract pathogens are common. A computerized medical
record review will be performed to evaluate appropriateness of antimicrobial therapy for
UTI, as well as to compare different treatments and their outcomes. One important measure
of quality will be the timeliness with which antimicrobial therapy is altered based upon
culture results. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Northwestern Memorial Hospital
Lance Peterson, MD (312) 908-8192 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
None |
| Annual Extramural Funding through 1998: |
$60,000 |
| Funding Mechanism |
Cooperative agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Epidemiology of Infections in Patients
Receiving Home Health Care |
| Category |
Research |
| Objectives and Descriptions: |
This project will: (1) determine the incidence
of infection among patients receiving medical care at home, (2) determine the risk factors
for developing infection among patients receiving medical care at home; and (3) develop
public health interventions that will prevent the emergence of infection in this setting.
A major goal will be to determine the incidence of infection among patients discharged
from acute care settings to home care settings - including patients with central venous
catheters, patients with open medical and surgical wounds, immunosuppressed patients, and
patients with other preexisting comorbidity. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Northwestern Memorial Hospital Lance Peterson, MD (312) 908-8192 |
| CDC Project Officer |
Ralph Cordell, PhD (404) 639-6475 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998: $75,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Control of Antimicrobial Resistance in
Integrated Health-Care Delivery Settings |
| Category |
Prevention Demonstration Project |
| Objectives and Descriptions: |
The leaders of this project will address the
problem of antimicrobial resistance by: (1) promoting more prudent antimicrobial use; (2)
taking action to reduce transmission of antimicrobial resistant microorganisms; (3)
preventing colonization and infection with resistant microorganisms through vaccination;
(4) enhancing the detection of resistant microorganisms through the institution of better
laboratory testing procedures and improvements in the quality and flow of laboratory data;
and (5) communicating more effectively with health-care providers to positively influence
their utilization of antimicrobials, utilizing technologies like automated information
management systems and Internet-based systems. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
Cook County Hospital, Cook County Bureau of
Health Services, Rush Presbyterian-St. Lukes Medical Center
Robert A. Weinstein, MD (312) 633-3237 |
| CDC Project Officer |
Steven L. Solomon, MD (404) 639-6476 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998: $500,000 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Testing a Revised HEDIS Measure of
Appropriate Antimicrobial Therapy for Acute Otitis Media |
| Category |
Research |
| Objectives and Description |
This study will evaluate a modified, proposed,
HEDIS measure of appropriateness of antimicrobial therapy for acute otitis media,
utilizing a health plan's electronic patient database. |
| Outcomes: |
|
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal
Investigator |
Harvard Community Health Plan
Richard Platt, MD, MSc (617) 421-6859
|
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Richard E. Besser, MD (404) 639-3057 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998: $20,000 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Intervening to Promote Judicious
Antibiotic Use in Primary Care Pediatrics within Managed Care Organizations |
| Category |
Research |
| Objectives and Description |
The goal of this project is to determine
whether antibiotic use by pediatric primary care providers can be decreased by educational
and feedback interventions aimed at providers, and education of patients. The study will
compare intervention and control group practices. |
| Outcomes: |
|
| Contractor/Project Manager |
Alliance of Community Health Plans
Michelle Tropper, MPH (732) 220-1388, Ext. 17 |
| Subcontractor/Principal
Investigator |
Harvard Community Health Plan
Jon FinkelsteinGroup Health Cooperative-Puget Sound
Robert L. Davis, MD, MPH (206) 287-2943 |
| CDC Project Officer |
Deborah Rogers Mercy (770) 488-8200 |
| CDC Technical Monitor(s) |
Scott Dowell, MD (404) 639-4646 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1996: $152,262 FY 1997 : $141, 424 |
| Funding Mechanism |
Contract |
| Project Status |
Ongoing |
| Special Populations |
Children |
| Published Abstracts/Articles |
|
| Title of Project |
Lyme Disease Vaccine and Health
Management Organizations (HMOs): Economics and an Algorithm for Its Use |
| Category |
Research |
| Objectives and Description |
This project will attempt to: (1) determine the
costs associated with Lyme disease among an HMO subscribing population; (2) perform a
cost-benefit analysis for using Lyme disease vaccine in one or more HMO populations; (3)
develop an algorithm as a decision-making tool for Lyme disease vaccination in an HMO
setting. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
University of Maryland (through Maryland Dept.
of Health)
Alan Fix, MD (410) 706-3491Thomas Strickland, MD, PhD (410) 706-7550 |
| CDC Project Officer |
David T. Dennis, MD, MPH (970) 221-6400 Kathleen A Orloski, DVM (970) 221-6400
Martin Meltzer, MS, PhD (404) 639-4643 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1998: $93,500 FY 1999: $105,010 |
| Funding Mechanism |
Cooperative Agreement |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
|
