Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

For, the disadvantage, elderly, females, minorities and those of varying alien status, the issue is what health services are available and promoted by health care providers in southern California, and are they effective. A thorough study of services provided and promoted is of particular concern in southern California given controversies involving differential treatment among different groups. Finally, given southern California's status one of the largest health care areas dealing with diverse populations, the study could provide many insights the health care treatment.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

no

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

The study would apply to different groups from the very young to the elderly, gender, alienage, ethnicity, degree of usage, and economic status.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

The study by its scope could include “stage in or severity of a disease.” Here, the most likely concern would be with regard to ethnic and gender differences.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

The benefits of interest include the level of health care service provided, competency of health care service as appraised by the user, the availability, and promotion (making people aware of such services).

Describe any health-related risks, side effects, or harms that you are concerned about.

The study as envisioned would not pose any physical or psychological risk. The data collection method would involve surveys, not the use of any drugs or medical devices.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

no

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

None

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

The provision of the priority conditions checked off above are especially important in southern California given the large populations of the economically disadvantaged, elderly, diverse ethnic groups, and alienage status. As to gender, the increased incidence of misdiagnosis with regard to heart and depression related conditions are seen by some as critical defect in the health care system.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

What created my current interest is the problems that have recently arose with regard to Kaiser Permanente. It appears that patients in need of medical treatment have been given faulty information after being referred via telephone to a nurse consultant. This trigger other concerns I have had with regard to female colleagues who have been misdiagnosed with regard to heart and depression problems that apparently would not have happened if they were male. Finally, the above issue brought up some of my past research interests in the elderly.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

My issue is mostly a matter for policy makers.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

The results will allow consumes of health care to be better informed of their risks. Policy makers can my group and I by implementing changes that reduce risk.

Describe the timeframe in which an answer to your question is needed.

From my experience, approximately one year will be needed. The research process will involve primarily studies to identify critical issues, development research collection methods, questionnaire development and testing, data collection, data input, data analysis, and finally report generation.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

The specific health care disparities and inequities apply to ethnic minorities, undocumented aliens, the economically disadvantaged. These groups traditionally have been vulnerable to inequities in the health care system. Additionally, given longer life spans, the elderly have now become a vulnerable population especially when combined with minority status, alienage, or economic circumstances. Finally, the differential treatment of certain diseases afforded women has left them particularly vulnerable to early death or incapacitation.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

The results will allow consumes of health care to be better informed of their risks. Policy makers can my group and I by implementing changes that reduce risk.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

None