AHRQ News Now: ICU ventilator patients, uninsured hospital patients

January 24, 2017, Issue #551 Opioid-Related Emergency Department Care Massachusetts, Rhode Island, Maryland, Ohio and Connecticut were the states with the highest rates of opioid-related emergency department visits in 2014. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #219: Opioid-Related Impatient Stays and Emergency Department Visits by State, 2009-2014.) Today's Headlines: AHRQ Toolkit Available for Protecting Safety of Intensive Care Patients on Ventilators Study Quantifies Uninsured Patients’ Use of Low-Quality Hospitals AHRQ Offers Updated Tutorials on Use of Hospital Database New Research and Evidence From AHRQ AHRQ Toolkit Available for Protecting Safety of Intensive Care Patients on Ventilators AHRQ’s new Toolkit To Improve Safety for Mechanically Ventilated Patients is available to help hospitals improve safety for mechanically ventilated patients in intensive care units (ICUs). The Web-based resource provides tools to help ICU staff follow recommended bedside care, support patient mobility as soon as possible to speed recovery, and apply protective ventilation practices to reduce potential complications. The toolkit allows staff to apply proven methods of AHRQ’s Comprehensive Unit-based Safety Program to reduce complications, including ventilator-associated pneumonia. Study Quantifies Uninsured Patients’ Use of Low-Quality Hospitals Hospital patients without insurance in 2009–2010 were less likely to receive care at a high-quality hospital compared with patients covered by Medicaid or private insurance, according to a new AHRQ study. The study concluded that since patients without insurance had lower use of high-quality hospitals, future research should examine how the Affordable Care Act has influenced their access to improved care. Findings showed the probability of being admitted to a high-quality hospital was similar for patients with Medicaid and private insurance (about 23 percent), but was significantly lower for patients without insurance (19.8 percent). The study stated that accounting for demographic, socioeconomic and clinical characteristics did not influence the results. Study authors used AHRQ’s Healthcare Cost and Utilization Project to examine data on nearly 875,000 patients treated at more than 1,800 hospitals in 18 states. Patients had a primary diagnosis of acute myocardial infarction, heart failure, pneumonia, stroke or gastrointestinal hemorrhage. A hospital’s level of quality was determined by its in-hospital mortality rate. “Differences in Use of High-Quality and Low-Quality Hospitals Among Working-Age Individuals by Insurance Type” and abstract were published in the February issue of Medical Care. AHRQ Offers Updated Tutorials on Use of Hospital Database AHRQ has revised online tutorials that help researchers and others use the agency’s Healthcare Cost and Utilization Project (HCUP). HCUP, the nation’s most comprehensive source of hospital data, includes national and state data on inpatient care, ambulatory care and emergency department visits. The updated HCUP Overview Course provides information about the sources of HCUP data, features of the database, software tools and products. Additional tutorials instruct users on how to calculate standard errors and how to load and check HCUP data. Contact HCUP User Support for questions about the HCUP Online Tutorial Series. New Research and Evidence From AHRQ Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children AHRQ in the Professional Literature Medicare and Medicaid reimbursement rates for nursing homes motivate select culture change practices but not comprehensive culture change. Lepore MJ, Shield RR, Looze J, et al.J Aging Soc Policy. 2015;27(3):215-31. Access the abstract on PubMed®. Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes. Crane S, Sloane PD, Elder N, et al. J Am Board Fam Med. 2015 Jul-Aug;28(4):452-60. Access the abstract on PubMed®. Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries. Gibson G, Jurasic MM, Wehler CJ, et al. J Am Dent Assoc. 2014 May;145(5):443-51. Erratum in: J Am Dent Assoc. 2014 Jun;145(6):528. Access the abstract on PubMed®. Age and sex differences in long-term outcomes following implantable cardioverter-defibrillator placement in contemporary clinical practice: findings from the Cardiovascular Research Network. Masoudi FA, Go AS, Magid DJ, et al. J Am Heart Assoc. 2015 Jun 2;4(6):e002005. Access the abstract on PubMed®. Developing and evaluating a website to guide older adults in their health information searches: a mixed-methods approach. Fink A, Beck JC. J Appl Gerontol. 2015 Aug;34(5):633-51. Epub 2013 Jul 19. Access the abstract on PubMed®. A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations. Jones CD, Vu MB, O'Donnell CM, et al. J Gen Intern Med. 2015 Apr;30(4):417-24. Epub 2014 Oct 15. Access the abstract on PubMed®. Navigating venous access: a guide for hospitalists. Simonov M, Pittiruti M, Rickard CM, et al. J Hosp Med. 2015 Jul;10(7):471-8. Epub 2015 Mar 6. Access the abstract on PubMed®. Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches. Stewart GL, Manges KA, Ward MM. J Nurs Care Qual. 2015 Jul-Sep;30(3):240-6. Access the abstract on PubMed®. Contact Information Please address comments or questions about AHRQ News Now to Bruce Seeman, (301) 427-1998, or Bruce.Seeman@ahrq