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HHS Secretary Sebelius Highlights AHRQ Reports on Health Care Quality and Disparities

Electronic Newsletter, Issue 275

Electronic Newsletter

May 13, 2009

AHRQ News and Numbers

Hospitals spent nearly $31 billion—10 percent of their total patient care budget in 2006—on more than 4 million U.S. patient stays that could possibly have been prevented with timely and effective ambulatory care. Reducing preventable hospitalizations is one way to lower America's $2.2 trillion medical bill. [Source: Agency for Healthcare Research and Quality, HCUP, Statistical Brief #72: Nationwide Frequency and Costs of Potentially Preventable Hospitalizations, 2006.]

Today's Headlines

  1. HHS Secretary Sebelius highlights AHRQ reports on health care quality and disparities
  2. New AHRQ study finds fewer families can afford health insurance
  3. AHRQ testifies to House panel on funding the VA of the future
  4. Surgery patients' injuries dramatically increase their chance of death or hospital readmission, AHRQ study finds
  5. New AHRQ-funded study finds electronic health record-based reminders improve tobacco cessation treatment
  6. Complications and costs for obesity surgery declining
  7. Higher financial burden of mental health/substance abuse treatment in the southern United States
  8. Register now for AHRQ's 2009 Annual Conference: Research to Reform: Achieving Health System Change on September 13-16
  9. Task Force reaffirms recommendations on counseling and interventions for tobacco use and updates recommendation on folic acid supplementation for the prevention of neural tube defects
  10. Call for papers: HSR theme issue: Payment Reform
  11. Highlights from our most recent monthly newsletter
  12. AHRQ in the professional literature

1.  HHS Secretary Sebelius Highlights AHRQ Reports on Health Care Quality and Disparities

In a May 9 speech to the United Nurses of America, Department of Health & Human Services's (HHS) Secretary Kathleen Sebelius discussed two new AHRQ reports on the quality of and disparities in health care in America and challenged nurses to work to reduce health care associated infections. The 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. Upon issuing the reports, Secretary Sebelius also announced the availability of $50 million in Recovery Act resources to fight health care associated infections and improve patient safety. Patient safety has declined in part because of this rise in health care associated infections (HAI), infections that patients acquire during the course of their stay in a healthcare setting, such as a nursing home or a hospital. Secretary Sebelius also called on hospitals across America to commit to reduce central line associated blood stream infections in intensive care units by 75 percent over the next three years. She challenged hospitals to make use of a proven patient-safety checklist that can significantly and dramatically reduce the rate of these life-threatening infections. Select to read the HHS press release and select to access the . Select to read the checklist.

2.  New AHRQ Study Finds Fewer Families Can Afford Health Insurance

The majority of uninsured American families who are not covered by group health insurance through an employer cannot afford to buy health insurance, according to a new AHRQ study. Some experts have suggested that because 23.8 million uninsured Americans under age 65 who do not have access to employer-based health insurance have incomes above the federal poverty line, they can afford to purchase policies if they so choose. But new data show otherwise. "Wealth, Income, and the Affordability of Health Insurance," published in the May/June 2009 issue of Health Affairs, shows that measuring families' median net worth—the value of their savings plus other assets minus debt rather than just income—provides more precise estimates of the percentage who could purchase policies if they chose to do so. Until now, most studies have used income alone to estimate how many more Americans could be covered by health insurance. Select to read our press release and select to access the abstract in PubMed®.

3.  AHRQ Testifies to House Panel on Funding the VA of the Future

The Department of Veterans Affairs (VA) Enrollee Health Care Projection Model is a very sophisticated model that benefits each year from better information on the current veteran population, according to AHRQ's Jessica Banthin, Ph.D., Director of Modeling and Simulation, who testified before the House Committee on Veterans' Affairs on April 29. She emphasized how AHRQ has benefited from extensive collaboration with the VA in the areas of health services research, patient safety, and clinical quality of care. She discussed our work with Centers for Medicare & Medicaid Services (CMS) to benchmark national health expenditure estimates on a simulation model developed by AHRQ that estimates the number of eligible uninsured children in the United States and can be used to project enrollment in Medicaid and the State Children's Health Insurance Program (SCHIP). Dr. Banthin emphasized that there are caveats associated with all long-term projection models, whether they use actuarial or economic methods, and the accuracy of all projection models depends critically on the available data. Without sufficient data there may be areas in the models that rely on best guesses rather than solid data. Select to read Jessica Banthin's testimony.

4.  Surgery Patients' Injuries Dramatically Increase their Chance of Death or Hospital Readmission, AHRQ Study Finds

Adult surgery patients who have injuries as a result of the procedure—including respiratory failure, infections, and lung puncture, or other types of accidental injuries—are seven times more likely to die while hospitalized than surgery patients who are not injured, according to a new AHRQ-funded study. The study, led by AHRQ's Bernard Friedman, Ph.D., also found that patients who suffered accidental injuries during or after surgery were much more likely to have to be readmitted to a hospital within 3 months of their initial hospital stay. They found that about 9 percent of the approximately 26,000 patients who were injured at least once during their stays died in the hospital after surgery, compared with 1.3 percent of the surgery patients who didn't suffer injuries. The study, "Do Patient Safety Events Increase Readmissions?" was published in the May issue of Medical Care. Select to read the abstract on PubMed®. A reprint copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

5. New AHRQ-Funded Study Finds Electronic Health Record-Based Reminders Improve Tobacco Cessation Treatment

Primary care clinicians counsel patients to quit smoking more often when they are prompted by an electronic health record, according to a new study supported by AHRQ and National Institutes of Health's (NIH) National Cancer Institute Clinicians participating in the study were part of the Partners Primary Care Practice-Based Research Network, a group of 26 primary care practices that currently use a Web-based electronic health record and are affiliated with Boston's Brigham and Women's Hospital and Massachusetts General Hospital. Clinicians in an intervention group received tobacco treatment-related reminders and icons; more than 40 percent of them used a new "Tobacco Smart Form," an addition to the electronic health record that prompted them to provide a range of smoking cessation interventions. Among patients who were smokers at the start of the study, more than twice as many (5.3 percent), who went to practices with the prompts or the form quit smoking by the end of the study, largely due to followup with a tobacco counselor (3.9 percent).

6. Complications and Costs for Obesity Surgery Declining

A new AHRQ-funded study found that the average rate of post-surgical and other complications in patients who have obesity surgery, also known as bariatric surgery, declined 21 percent between 2002 and 2006. They also found that payments to hospitals dropped by as much as 13 percent for bariatric surgery patients during that time period, in part because fewer complications meant fewer readmissions. The study, "Recent Improvements in Bariatric Surgery Outcomes," was published in the May 2009 issue of Medical Care; it found that the complication rate among patients initially hospitalized for bariatric surgery dropped from approximately 24 percent to roughly 15 percent. Much of this was driven by a reduction in the post-surgical infection rate, which plummeted 58 percent. Select to read our press release and select to access the abstract in PubMed®. A reprint copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

7.  Higher Financial Burden of Mental Health/Substance Abuse Treatment in the Southern United States

About 11 percent of people using outpatient mental health and substance abuse treatment in the Southern United States used more than 5 percent of their family's annual income to cover their out-of-pocket treatment costs between 2001-2005, according to a new study by AHRQ researchers. Such spending includes patient out-of-pocket costs for psychiatrists, psychologists, social workers, and other specialty providers as well as mental health treatment provided by primary care physicians and the out-of-pocket costs of psychotropic medications. People living in the southern United States paid the highest percentage of treatment costs out of their own pockets because they were the most likely to use prescription medications for their treatment and they paid the greatest share (39 percent) of the costs of these medications. AHRQ economist Samuel Zuvekas, Ph.D., and Chad Meyerhoefer, Ph.D., a professor of economics with Lehigh University, co-authored the study, "State Variations in the Out-of-Pocket Spending Burden for Outpatient Mental Health Services," which was published in the May/June 2009 issue of Health Affairs. Select to access the abstract in PubMed®.

8. Register Now for AHRQ's 2009 Annual Conference: Research to Reform: Achieving Health System Change on September 13-16

Register now for AHRQ's third annual conference, scheduled for September 13-6, at the Bethesda North Marriott Convention Center in Bethesda, MD. Leading authorities in health care research and policy will hold sessions on health care infrastructure, delivery of services, quality and safety, improving Americans' health status, provider performance and payment reform, and patient engagement.

9. Task Force Reaffirms Recommendations on Counseling and Interventions for Tobacco Use and Updates Recommendation on Folic Acid Supplementation to Prevent Neural Tube Defects

The U.S. Preventive Services Task Force reaffirms that using evidence-based cessation interventions in adults and pregnant women can lead many to quit using tobacco products and improve their health. The Task Force reviewed new evidence in the U.S. Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence, 2008 Update, to reissue its 2003 recommendation on counseling and interventions for tobacco use. The Task Force continues to urge all clinicians to ask all adults, 18 years or older, about tobacco use and provide tobacco cessation interventions for those who use tobacco products. Clinicians are also urged to ask all pregnant women, regardless of age, about tobacco use and provide more pregnancy-tailored counseling for those who smoke. The new recommendation is published in the April 21 issue of the Annals of Internal Medicine. Select to access the recommendation. In addition, the Task Force has updated its 1996 recommendation that all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid. The recommendation was published in the May 5 issue of Annals of Internal Medicine. Select to access the recommendation.

10.  Call for Papers for AHRQ-Sponsored Health Services Research Theme Issue

AHRQ is sponsoring the second theme issue for Health Services Research on "Impacting Health Practice and Policy Through State-of-the-Art Research and Thinking." HSR is seeking abstracts on research results, evaluations, or policy analyses on payment reform. The deadline for submission is June 23. Select to read the announcement

11.  Highlights from Our Most Recent Monthly Newsletter

The May issue of Research Activities is available online. Key articles include:

  • Simple, effective methods to promote increased physical activity introduced to older American Indians in a primary care setting yield positive results.

Studies of geographically diverse American Indian tribes consistently show low levels of leisure-time physical activity, less frequent exercise, and a higher proportion being classified as sedentary. Researchers led by Craig N. Sawchuk, Ph.D., of the University of Washington found that physical activity among American Indian elders (aged 50-74) can be promoted in a brief, inexpensive manner in primary care. Select to read this article.

Other articles include:

  • Tracking system ensures women with breast cancer see oncologists and receive additional treatment.
  • Duration of illness strongly influences practitioners to prescribe antibiotics in treating acute respiratory tract infections.
  • Giving patients drugs that interfere with fluoroquinolone antibiotic absorption may lead to resistant infections.

Select to read these articles and others.

12.  AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Buckelew SM, Yu J, English A, et al. Innovations in preventive mental health care services for adolescents. J Adol Health 2008 May, 42 (95):519-25. Select to access the abstract in PubMed®.

Cooper WO, Hernandez-Diaz S, Gideon P, et al. Positive predictive value of computerized records for major congenital malformations. Pharmacoepidemiol Drug Saf 2008 May; 17(5):455-60. Select to access the abstract in PubMed®.

Katz DA, Aufderheide TP, Bogner M, et al. Do emergency department patients with possible acute coronary syndrome have better outcomes when admitted to cardiology versus other services? Ann Emerg Med 2008 May; 51(5):561-70. Select to access the abstract in PubMed®.

Stille CJ, Rifas-Shiman SL, Kleinman K, et al. Physician responses to a community-level trial promoting judicious antibiotic use. Ann Fam Med 2008 May-Jun; 6(3):206-12. Select to access the abstract in PubMed®.

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Current as of May 2009
Internet Citation: HHS Secretary Sebelius Highlights AHRQ Reports on Health Care Quality and Disparities: Electronic Newsletter, Issue 275. May 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/news/newsletters/e-newsletter/275.html

 

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