AHRQ Electronic Newsletter, August 25, 2015, Issue #484
August 25, 2015 Issue
AHRQ Stats: Mortality Rate for Heart Failure and Stroke
Between 2002 and 2012, decreases in
congestive heart failure and stroke mortality were largest for patients in the
poorest communities (34 percent and 30 percent respectively) and smallest for
those in the wealthiest communities (24 percent and 23 percent respectively).
(Source: Agency for Healthcare Research and Quality, Healthcare Cost and
Utilization Project Statistical Brief #194: Trends in Observed Adult Inpatient Mortality for
High-Volume Conditions, 2002-2012.)
Hospital Readmissions of Children May Be
Underestimated, New Study Says
Failure to track hospital readmissions to
different hospitals can underestimate readmissions of children by as much as
13.9 percent, according to a new study in the journal JAMA Pediatrics.
Hospital readmission rates are a common measure of hospital quality.
Same-hospital readmission rates (SHRs) are most commonly tracked and reported.
Hospitals usually lack data on different-hospital readmissions (DHRs) – that is,
whether their patients are readmitted within a specific timeframe to a different
hospital. In this AHRQ-funded study, researchers sought to determine the rate of
30-day pediatric DHRs. They analyzed 701,263 pediatric discharges from 177
acute-care hospitals in New York over a five-year period to identify an SHR
rate, a DHR rate and an all-hospital readmission rate. The researchers concluded
that DHRs, which constituted 13.9 percent of all readmissions in the study,
affect all-hospital readmission rates and make SHRs an incomplete measure of
readmissions and thus of quality. The study and abstract, “Same-Hospital Readmission Rates as a Measure of
Pediatric Quality of Care,” were published August 3.
Newborn and Maternal Hospitalizations Related to
Substance Abuse on the Rise, According to New AHRQ Brief
Between 2006 and 2012, the rate of newborn
(neonatal) hospitalizations related to substance use increased by 71 percent,
from 5.1 to 8.7 per 1,000 stays, according to a recently published statistical brief from AHRQ's Healthcare Cost and Utilization
Project (HCUP). HCUP data also show that the rate of maternal hospitalizations
related to substance use increased by 33 percent, from 13.4 to 17.9 per 1,000
stays during that period. Total associated hospital costs for that period rose
by 135 percent, from $253 to $595 million, for neonatal hospitalizations, and by
35 percent, from $258 to $349 million, for maternal hospitalizations. While the
rate of maternal hospital stays for cocaine use fell by 50.5 percent, the rate
of maternal hospital stays for opiate use rose by 134.7 percent. Twenty percent
of neonatal stays with a substance-related condition had low birth weight,
compared with 7 percent of all other neonatal stays. The brief also said that in
2012, mental disorders were indicated in 25 percent of maternal stays related to
substance use, compared with 4 percent of other maternal stays. An AHRQ infographic highlights these findings.
Magnetic Resonance Imaging, Computed Tomography
Provide Higher Sensitivity for Liver Cancer Diagnosis: AHRQ Review
The use of magnetic resonance imaging (MRI)
and computed tomography (CT) to diagnose liver cancer is associated with higher
sensitivity than ultrasonography without contrast, according to an AHRQ-funded
literature review of different imaging techniques. Sensitivity refers to the
ability of the test to correctly identify individuals with the disease.
Worldwide, liver cancer is the fifth most common type of cancer and the third
most common cause of death from cancer. The systematic review and meta-analysis,
published in the journal Annals of Internal Medicine, included data
from 1998 through 2014. It found that sensitivity was higher for MRI than for
CT. For evaluation of focal liver lesions, sensitivities for the three imaging
modalities were similar. The review, “Imaging Techniques for the Diagnosis of
Hepatocellular Carcinoma: A Systematic Review and Meta-analysis,” and abstract were published May 19
AHRQ’s Health Care Innovations Exchange Focuses on
Reducing Emergency Care by Connecting Frequent Users to Community-Based
The latest issue of AHRQ’s Health Care Innovations Exchange features three
programs that reduced emergency department use by providing access to
community-based services for frequent 911 callers and at-risk individuals. One
of the profiles describes the Michigan Pathways to Better Health program, in
which a community health worker partners with local emergency service providers
to identify and refer at-risk individuals to community-based care. Key elements
of the program include education of emergency service providers about Michigan
Pathways to Better Health and those who might benefit from it, steps to make
referrals to the program as easy as possible and financial support to cover a
portion of the additional costs involved. The partnerships have enhanced access
to needed community-based services, leading to less reliance on emergency care
among frequent 911 callers.
Featured Impact Case Study: Wisconsin Critical
Access Hospital Achieves Multiple Improvements With AHRQ Patient Safety Tools
Bakullari A, Metersky ML, Wang Y, et al.
Racial and ethnic disparities in healthcare-associated infections in the United
States, 2009-2011. Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl
3:S10-6. Select to access the abstract on PubMed®.
Kahvecioglu D, Ramiah K, McMaughan D, et al.
Multidrug-resistant organism infections in US nursing homes: a national study of
prevalence, onset, and transmission across care settings, October 1,
2010-December 31, 2011. Infect Control Hosp Epidemiol. 2014 Oct;35
Suppl 3:S48-55. Select to access the abstract on PubMed®.
Greene MT, Fakih MG, Fowler KE, et al.
Regional variation in urinary catheter use and catheter-associated urinary tract
infection: results from a national collaborative. Infect Control Hosp
Epidemiol. 2014 Oct;35 Suppl 3:S99-106. Select to access the abstract on PubMed®.
Powell ES, Khare RK, Courtney DM, et al. The
weekend effect for patients with sepsis presenting to the emergency department.
J Emerg Med. 2013 Nov;45(5):641-8. Epub 2013 Aug 30. Select to access
the abstract on PubMed®.
Lee CI, Jarvik JG. Patient-centered outcomes
research in radiology: trends in funding and methodology. Acad Radiol.
2014 Sep;21(9):1156-61. Epub 2014 Jul 4. Select to access the abstract on PubMed®.
Chung S, Azar KM, Baek M, et al.
Reconsidering the age thresholds for type II diabetes screening in the U.S.
Am J Prev Med. 2014 Oct;47(4):375-81. Epub 2014 Aug 15. Select to access
the abstract on PubMed®.
Gupta S, Brenner AT, Ratanawongsa N, et al.
Patient trust in physician influences colorectal cancer screening in low-income
patients. Am J Prev Med. 2014 Oct;47(4):417-23. Epub 2014 Jul 29.
Select to access the abstract on PubMed®.
Jarrín O, Flynn L, Lake ET, et al. Home
health agency work environments and hospitalizations. Med Care. 2014
Oct;52(10):877-83. Select to access the abstract on PubMed®.
Please address comments and questions about
the AHRQ Electronic Newsletter to Jeff Hardy at: (301) 427-1802