AHRQ Helps Establish Consortium Aimed at Using Data To Improve Care for COVID-19 Patients

AHRQ Stats: Gender and Emergency Department Visits

Of the nation’s $76.3 billion cost for emergency department visits in 2017, 56 percent of visits were for females at a cost of $42.6 billion while 44 percent were for males at a cost of $33.7 billion. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #268: Costs of Emergency Department Visits in the United States, 2017.)

Today's Headlines:

• AHRQ Helps Establish Consortium Aimed at Using Data To Improve Care for COVID-19 Patients.
• Analysis Recommends Against Skipping Earliest Vaccines Developed for COVID-19.
• Highlights From AHRQ’s Patient Safety Network.
• Medicare Expansion Could Improve Access, Affordability for Americans, AHRQ Study Finds.
• AHRQ Study Examines Role of Physician Decision-Making in Hospital Admissions.
• AHRQ in the Professional Literature.

AHRQ Helps Establish Consortium Aimed at Using Data To Improve Care for COVID-19 Patients

AHRQ has assisted HCA Healthcare in establishing a research and analysis consortium announced on Jan. 26 that will use HCA’s data on COVID-19 hospital care to improve patient outcomes and public knowledge. Nashville-based HCA, one of the nation’s largest healthcare providers, operates more than 2,000 sites of care, including 187 hospitals. AHRQ’s participation is part of the agency’s efforts to leverage its data expertise and use of predictive analytics to improve healthcare decision-making. The new consortium, of which AHRQ is a member, will provide a collaborative framework to allow academic and AHRQ researchers to partner with HCA to pose and test research questions about COVID-19 treatment. Early projects will evaluate the efficacy and safety of current treatments used for COVID-19. Insights may lead to future clinical trials. Among the institutions included in the consortium are the University of California San Francisco, Johns Hopkins University, Duke University, Meharry Medical College and Harvard Pilgrim Health Care Institute.

Analysis Recommends Against Skipping Earliest Vaccines Developed for COVID-19

A new analysis of potential vaccination strategies to prevent the spread of the virus that causes COVID-19 concludes that it is not advisable to skip the first available vaccine in favor of waiting for a subsequent vaccine that is potentially more effective. Researchers partially funded by AHRQ noted that, during a pandemic, there are situations in which the first available vaccine may not be as effective as vaccines that are under development or that are ready but not yet available. A computational model developed by the researchers showed that waiting for a future vaccine—even if it offered substantially higher efficacy—could lead to more hospitalizations and higher costs. For example, the analysis indicates that, if a vaccine with 50 percent efficacy becomes available when 10 percent of the population has already been infected, then waiting for and then deploying a vaccine with 80 percent efficacy after 40 percent of the population has become infected would result in 15.6 million additional cases and 1.5 million additional hospitalizations. Access the article published in the American Journal of Preventive Medicine.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers.
• System issues leading to "found-on-floor" incidents: a multi-incident analysis.
• Will the COVID-19 pandemic transform infection prevention and control in surgery? Seeking leverage points for organizational learning.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Medicare Expansion Could Improve Access, Affordability for Americans, AHRQ Study Finds

Expanding Medicare eligibility to a wider swath of Americans could improve healthcare access and affordability, according to a new AHRQ study published in Health Affairs. The analysis, based in part on data from AHRQ’s Medical Expenditure Panel Survey-Household Component, examined changes in access and affordability for people around age 65, when most Americans gain eligibility for Medicare. The author concluded that Medicare eligibility was associated with a 1.5 percentage-point reduction in reports of being unable to get necessary care and a 4.1 percentage-point reduction in delaying needed care because of cost. The study found no evidence of deteriorating healthcare access or affordability when people turn 65. The research suggests Medicare expansions could have benefits for access and affordability compared with the insurance coverage available to them before they become eligible for Medicare. Access the abstract.

AHRQ Study Examines Role of Physician Decision-Making in Hospital Admissions

Emergency department (ED) physicians’ admission rates for similar patients vary widely within and across hospitals, suggesting opportunities to develop strategies to optimize admission decisions, according to an AHRQ-funded study in Health Affairs. The national study, based on nearly 5.8 million ED visits by Medicare fee-for-service patients from 2012 to 2015, found that admission rates varied substantially—from 32 to 46 percent—among ED physicians even within the same hospital. Researchers found that admission rates were not due to differences in patients seen, as little variation was shown in patient characteristics. The wide range in admissions offers an opportunity to modify physician behavior through interventions such as clinical pathways for specific conditions or feedback of physician admission metrics, researchers said. Access the study abstract.

AHRQ in the Professional Literature

Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study. Mohr NM, Pape SG, Runde D, et al. Acad Emerg Med 2020 Nov;27(11):1140-9. Epub 2020 Jul 20. Access the abstract on PubMed®.

Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement. Scott HF, Brilli RJ, Paul R, et al. Crit Care Med 2020 Oct;48(10):e916-e26. Access the abstract on PubMed®.

The financial impact of an avoided readmission for teaching and safety-net hospitals under Medicare's hospital readmission reduction program. Hoffman GJ, Tilson S, Yakusheva O. Med Care Res Rev 2020 Aug;77(4):324-33. Epub 2018 Aug 24. Access the abstract on PubMed®.

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college. Jackman KP, Murray S, Hightow-Weidman L, et al. PLoS One 2020 Aug 21;15(8):e0237648. Access the abstract on PubMed®.

What safety events are reported for ambulatory care? Analysis of incident reports from a Patient Safety Organization. Sharma AE, Yang J, Del Rosario JB, et al. Jt Comm J Qual Patient Saf 2021 Jan;47(1):5-14. Epub 2020 Aug 21. Access the abstract on PubMed®.

Are health systems redesigning how health care is delivered? Scanlon DP, Harvey JB, Wolf LJ, et al. Health Serv Res 2020 Dec;55(Suppl 3):1129-43. Access the abstract on PubMed®.

Predicting preventable hospital readmissions with causal machine learning. Marafino BJ, Schuler A, Liu VX, et al. Health Serv Res 2020 Dec;55(6):993-1002. Epub 2020 Oct 30. Access the abstract on PubMed®.

Association of organizational factors and physician practices' participation in alternative payment models. Ouayogodé MH, Fraze T, Rich EC, et al. JAMA Netw Open 2020 Apr;3(4):e202019. Access the abstract on PubMed®.