AHRQ Electronic Newsletter, March 24, 2015, Issue #463

March 24, 2015, Issue #463 AHRQ Stats: The Newly Insured Between early 2013 and early 2014, about 30 percent of uninsured nonelderly adults gained health insurance coverage. That rate is higher than the 25 percent of those initially uninsured who acquired coverage during a similar time period in 2012 and 2013. Uninsured nonelderly adults in fair/poor or good health (rather than those in very good or excellent health) in early 2013 were substantially more likely to have gained coverage in 2014 than their counterparts during the 2012–2013 period. (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief # 467: Transitions in Health Insurance Coverage Over Time, 2012-2014 (Selected Intervals): Estimates for the U.S. Civilian Noninstitutionalized Adult Population under Age 65.) Today's Headlines: AHRQ Study Examines Effectiveness of Measures To Control Blood Sugar AHRQ Report Assesses Therapies for Menopause AHRQ’s Health Care Innovations Exchange Focuses on Supporting Caregivers of Patients With Dementia Register Now for MEPS Data Users’ Workshop April 28–29 Register Now for April 30 HCUP Data Users’ Workshop AHRQ Study Examines Effectiveness of Measures To Control Blood Sugar An AHRQ-supported study published in the journal Endocrine Practice found that a multidisciplinary intervention was effective in treating uncontrolled hyperglycemia and iatrogenic hypoglycemia among nearly 23,000 patients at an academic medical center. Findings showed consistent improvements in glycemic control over time, ultimately cutting severe inpatient hypoglycemia by more than half, as well as reductions in the length of hospital stays. From 2009 to 2013, AHRQ grantee Greg Maynard, M.D., and colleagues at the University of California, San Diego, studied the effectiveness of the intervention, which included a hypoglycemia reduction bundle (such as order sets and education), daily measurement of glycemic outliers with concurrent intervention, and clinical decision support. The interventions addressed common occurrences that impact glycemic control in hospitals, such as inappropriate insulin prescribing, failure to address unexpected nutritional interruption and failure to respond appropriately to the first hypoglycemic event. “Impact of a Hypoglycemia Reduction Bundle and a Systems Approach to Inpatient Glycemic Management” and the abstract were published online December 22, 2014. AHRQ Report Assesses Therapies for Menopause A new comparative effectiveness review from AHRQ examined the benefits and harms of treatments for menopause, including prescription, nonprescription and complementary therapies. The report assesses treatments and therapies for the symptoms of menopause, specifically hot flashes, sleep disturbance, psychologic symptoms, urogenital atrophy and sexual function. It evaluated a number of treatments, including the use of hormonal therapies (estrogen, alone or with progestogen or androgen), selective serotonin reuptake inhibitors and eszocpiclone. Both improvement in menopausal symptoms and adverse events were evaluated. The title of the review is “Menopausal Symptoms: Comparative Effectiveness of Therapies.” AHRQ’s Health Care Innovations Exchange Focuses on Supporting Caregivers of Patients With Dementia The March issue of AHRQ’s Health Care Innovations Exchange features three programs that used innovative strategies to support caregivers of patients with dementia. One of the profiles describes a program that uses trained consultants throughout the state of North Dakota who conduct in-depth initial assessments with caregivers of dementia patients. The assessments offer caregivers emotional support, education about the typical progression pattern for dementia and referrals to local support services. The consultant and the caregiver then work together to develop a specific care plan that will help support the caregiver and their patient. Afterward, the consultant provides ongoing support through follow-up conversations. By alleviating the burden on caregivers, the program has reduced the need for costly medical services for patients and placement in long-term care facilities. These reductions have generated an estimated $40 million in savings across the state, primarily due to the reductions in likelihood of long-term care. Register Now for MEPS Data Users’ Workshop April 28–29 Registration is open for a two-day, hands-on data users' workshop on the Medical Expenditure Panel Survey (MEPS) April 28–29 in Rockville, Maryland. Day one of the workshop consists of lectures that provide a general overview of MEPS, including information about survey design, file content and the construction of analytic files. Particular emphasis will be on health care utilization, expenditures and medical conditions. On the second day, a laptop will be provided for each participant to use to apply the knowledge gained from the previous day's lectures and work with programmers and analysts on MEPS data. To fully benefit from the second day, participants should have some prior knowledge of MEPS. A basic knowledge of SAS software is desirable, but not essential. Register Now for April 30 HCUP Data Users’ Workshop Registration is open for the HCUP Data Users’ Workshop scheduled for April 30 at AHRQ headquarters in Rockville, Maryland. This one-day hands-on workshop provides participants with experience working with Healthcare Cost and Utilization Project (HCUP) resources, providing in-depth exposure to several HCUP databases and tools. The focus will be on the newly redesigned 2012 National Inpatient Sample. Faculty will be available for consultation on how HCUP data can support participants’ research interests. Instructional and reference materials will be distributed and discussed. Given the content and pace of this course, prior experience with large administrative databases or with HCUP is recommended. Registrants may find it helpful to take HCUP’s April 15 and April 22 HCUP webinar series overview presentations or to review the Online HCUP Overview Course prior to the workshop. There is no charge for the webinars, online overview course or the workshop. HCUP registration information is available here. Email questions to hcup@ahrq.gov. AHRQ in the Professional Literature Stineman MG, Kwong PL, Bates BE, et al. Development and validation of a discharge planning index for achieving home discharge after hospitalization for acute stroke among those who received rehabilitation services. Am J Phys Med Rehabil. 2014 Mar;93(3):217-230. Select to access the abstract on PubMed®. Moore JE, Low LK, Titler MG, et al. Moving toward patient-centered care: women's decisions, perceptions, and experiences of the induction of labor process. Birth. 2014 Jun;41(2):138-46. Epub 2014 Apr 6. Select to access the abstract on PubMed®. Meddings J, Rogers MA, Krein SL, et al. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf. 2014 Apr;23(4):277-89. Epub 2013 Sep 27. Select to access the abstract on PubMed®. Treadwell JR, Lucas S, Tsou AY. Surgical checklists: a systematic review of impacts and implementation. BMJ Qual Saf. 2014 Apr;23(4):299-318. Epub 2013 Aug 6. Select to access the abstract on PubMed®. Weaver SJ, Dy SM, Rosen MA. Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf. 2014 May;23(5):359-72. Epub 2014 Feb 5. Select to access the abstract on PubMed®. Raghavan R, Brown DS, Allaire BT, et al. Racial/ethnic differences in Medicaid expenditures on psychotropic medications among maltreated children. Child Abuse Negl. 2014 Jun;38(6):1002-10. Epub 2014 Mar 16. Select to access the abstract on PubMed®. Wang F, Stone E, Skubic M, et al. Toward a passive low-cost in-home gait assessment system for older adults. IEEE J Biomed Health Inform. 2013 Mar;17(2):346-55. Select to access the abstract on PubMed®. Morris MS, Deierhoi RJ, Richman JS, et al. The relationship between timing of surgical complications and hospital readmission. JAMA Surg. 2014 Apr;149(4):348-54. Select to access the abstract on PubMed®. Contact Information Please address comments and questions about the AHRQ Electronic Newsletter to Linwood Norman at: (301) 427-1248 or Linwood.Norman@ahrq.hhs.gov.