Wednesday, January 6, 2016

AHRQ Electronic Newsletter, January 5, 2016

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January 5, 2016, Issue #500

We’ve Reached 500 Issues!
Friends – if you look at today’s masthead, you’ll notice we’ve reached a milestone: the 500th issue of the AHRQ Electronic Newsletter. Since our first issue on February 11, 2000, we’ve strived to keep you informed about activities at AHRQ and new developments in the world of health services research. Today we’re proud to have 111,844 subscribers, and we’re more committed than ever to make the AHRQ Electronic Newsletteraccessible, informative, timely and relevant. We’re always looking for ways to improve, so we’d be grateful for your suggestions and feedback (both positive and negative!). And please consider passing along this link so that friends and colleagues can join us. Here’s to the next 500 issues!

AHRQ Stats: Veterans’ Access to Care
From 2009 to 2012, about 92 percent of U.S. veterans with public insurance had a usual place to go for medical care when they got sick. Having a usual place to go was less likely for veterans with private insurance (88 percent) and veterans who were uninsured (65 percent). (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief #479: Veterans’ Usual Source of Care, 2009-2012: Estimates for the U.S. Civilian Noninstitutionalized Population.)

Today's Headlines:

Affordable Care Act Produced Little Change in Part-Time Employment, New AHRQ Study Finds
The Affordable Care Act’s coverage provisions and employer mandate produced limited evidence of an increase in part-time employment, a new AHRQ study has found. Using data from the Census Bureau’s Current Population Survey, the study did not find increases in the frequency of employees working in either of two part-time categories: 25–29 hours per week or fewer than 25 hours per week. Those findings applied to 2013, 2014 and the first half of 2015. Researchers also did not find a reduction in 2014 or 2015 in the frequency of employees working 30–34 hours, which the study said may have been expected based on the speculation that employers would seek to avoid the insurance mandate by reducing employee work hours below the 30-hour threshold. Modest increases in part-time employment were shown among workers with limited education, as well as among workers ages 60–64. The study, “Little Change Seen in Part-Time Employment As A Result of the Affordable Care Act,” and abstract appeared in the January issue of Health Affairs.

AHRQ Study: Medicaid Expansion Did Not Lead to Major Job Changes in 2014
Medicaid expansion under the Affordable Care Act did not lead to major labor market changes during the first 15 months of the law’s enactment, according to a new AHRQ study. Based on data from the Census Bureau’s Current Population Survey, an interview of approximately 60,000 households monthly, the study assessed the impact of the expansion of Medicaid coverage on low-wage workers by analyzing job loss, job switching and full- versus part-time status. The study found that nationwide, job losses would be no greater than 2.2 percent, an increase in job switching no greater than 1.2 percent, and an increase in the likelihood of switching from full-time to part-time employment no greater than 1.6 percent. “Medicaid Expansion Did Not Result in Significant Employment Changes or Job Reductions in 2014” and abstract were published in the January issue of Health Affairs.

AHRQ Study Examines Quality of Care, Length of Stay in Emergency Departments
If the quality of care in emergency departments (EDs) is measured by how long patients stay in the ED, measures should take into account the broad array of patient conditions and treatment needed, according to an AHRQ study. The research also concluded that ED quality could be measured and improved by standardizing the definition of “length of stay.” “Promoting such standards can enable EDs to compare ED stays fairly and guide improvements that yield a more timely and efficient patient experience,” said lead author Ernest Moy, M.D., M.P.H., of AHRQ. “Though considerable work remains before standards for collecting such data are clear and facilities collect such data consistently, it would create powerful incentives for hospitals to improve the ED services they provide.” The study, using AHRQ’s Healthcare Cost and Utilization Project data from 2011, examined more than 8.2 million ED visits among nearly 190 community nonrehabilitation hospitals in Florida. It ranked the 10 most common first-listed conditions among all ED visits, finding that the longest stays involved nonspecific chest pain (7.4 hours for discharged patients), urinary tract infections or mood disorders (4.8 hours for admitted patients) and schizophrenia or other psychiatric disorders (9.6 hours for transferred patients). The study also compared differences in using mean and median statistical calculations to measure ED length of stay. “Length of Stay in Emergency Departments: Variation Across Classifications of Clinical Condition and Patient Discharge Disposition” was published September 22 in The American Journal of Emergency Medicine. Access the abstract.

AHRQ Researchers Examine How Much Hospitals Are Paid for Inpatient Care
The amount that hospitals are paid for inpatient care can be estimated with moderate accuracy for patients covered by Medicare, Medicaid or private insurance, according to an AHRQ study. Using AHRQ’s Healthcare Cost and Utilization Project data and Medicare data from 2006, researchers reviewed inpatient charges from more than 1,000 community hospitals in 10 states. They then applied a “payment-to-charge” calculation that converted a hospital’s charges to an estimated payment for the inpatient care provided. Study authors stated that this calculation is currently the only method available to estimate fee-for-service payment for privately insured hospital stays, which represent a sizable amount of stays for patients younger than 65. “Predicting Inpatient Hospital Payments in the United States: A Retrospective Analysis” and abstract were published September 10 in BMC Health Services Research.

New Research and Data From AHRQ

Featured Case Study: AHRQ Toolkit Supports Development of Test for Antibiotic-Resistant Infections
An AHRQ toolkit helped the University of Louisville Hospital in Louisville, Kentucky, implement a gene test that can detect and track carbapenem-resistant Enterobacteriaceae and other multi-drug resistant organisms using molecular genetic techniques and bioinformatics. Read the case study.
AHRQ in the Professional Literature

Initial trends in the use of the 21-gene recurrence score assay for patients with breast cancer in the Medicare population, 2005-2009. Dinan MA, Mi X, Reed SD, et al. JAMA Oncol. 2015 May;1(2):158-66. Access the abstract on PubMed®.
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status. Reistetter TA, Kuo YF, Karmarkar AM, et al. Arch Phys Med Rehabil. 2015 Jul;96(7):1248-54. Epub 2015 Mar 4. Access the abstract on PubMed®.
Implementation of an audio computer-assisted self-interview (ACASI) system in a general medicine clinic: patient response burden. Trick WE, Deamant C, Smith J, et al. Appl Clin Inform. 2015 Mar 18;6(1):148-62. Access the abstract on PubMed®.
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network. Agwu AL, Lee L, Fleishman JA, et al. J Adolesc Health. 2015 Mar;56(3):345-51. Access the abstract on PubMed®.
Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study. Desai RJ, Huybrechts KF, Hernandez-Diaz S, et al. BMJ. 2015 May 14;350:h2102. Access the abstract on PubMed®.
How hospitals reengineer their discharge processes to reduce readmissions. Mitchell SE, Martin J, Holmes S, et al. J Healthc Qual. 2015 May 13. Access the abstract on PubMed®.
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer. Lairson DR, Parikh RC, Cormier JN, et al. Pharmacoeconomics. 2014 Oct;32(10):1005-13. Access the abstract on PubMed®.
National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use. Dresden SM, O’Connor LM, Pearce CG, et al. Ther Hypothermia Temp Manag. 2015 Mar;5(1):48-54. Epub 2015 Jan 7. Access the abstract on PubMed®.

Contact Information
Please address comments and questions about the AHRQ Electronic Newsletter to Bruce Seeman at: (301) 427-1998 or

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