Medicare Payments for Device Implant Surgery Were Higher for Hospitals With High Infection Rates

AHRQ Stats: Antidepressant Prescriptions for Seniors

The number of people age 65 or older who purchased at least one antidepressant prescription increased from 8.5 million in 2013 to 10.6 million in 2018. Those purchasing at least one antipsychotic prescription rose from 600,000 to 1 million during the same period. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #535: Comparison of the Total Number of People in the U.S. Civilian Noninstitutionalized Population Purchasing One or More Antidepressant or Antipsychotic Prescriptions by Select Sociodemographic Characteristics, 2013 and 2018.)

Today's Headlines:

• Medicare Payments for Device Implant Surgery Were Higher for Hospitals With High Infection Rates.
• Grantee Profile Highlights Work of James Ralston, M.D., M.P.H., To Improve Care of Patients With Multiple Chronic Conditions.
• Social Risk Screening at Health-System Owned Practices Impacted by Practice Factors.
• Highlights From AHRQ’s Patient Safety Network.
• Better Patient Care Experiences Positively Impact Business Outcomes.

Medicare Payments for Device Implant Surgery Were Higher for Hospitals With High Infection Rates

Medicare payments for surgery to implant long-term ventricular assist devices (VADs) were highest in U.S. hospitals with the highest healthcare-associated infection (HAI) rates, according to an AHRQ-funded study published in The Journal of Thoracic and Cardiovascular Surgery. The authors analyzed data for 8,688 Medicare beneficiaries receiving VAD implants in 120 hospitals from July 2008 to July 2017. They found that average Medicare payments for care provided from implant to 90 days post implant were roughly $166,170 in hospitals in the highest third of risk-adjusted HAI rates, compared with $152,518 in hospitals in the lowest third. The authors suggested that interventions to prevent such infections could improve outcomes and reduce VAD-associated costs. Access the abstract.

Grantee Profile Highlights Work of James Ralston, M.D., M.P.H., To Improve Care of Patients With Multiple Chronic Conditions

The work of James Ralston, M.D., M.P.H., who has dedicated his research career to develop innovative care models for patients with multiple chronic conditions, is the subject of the latest AHRQ grantee profile. Dr. Ralston has fostered patients’ ability to manage their conditions and leveraged technology to help optimize their care and outcomes. Access Dr. Ralston’s profile as well as additional AHRQ profiles. 

Social Risk Screening at Health-System Owned Practices Impacted by Practice Factors

Healthcare system capabilities account for less variation in physician practice adoption of social risk screening compared with practice-level capabilities, according to a study funded through AHRQ’s Comparative Health System Performance Initiative and published in Health Care Management Review. Of 781 health system-owned practices included in the 2018 National Survey of Healthcare Organizations and Systems, each screened for fewer than two of five social risk factors on average. Efforts to improve social risk screening should address variations in health information technology capacity, innovation culture and patient engagement strategies, according to the study authors. Access the abstract.

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:

• Structural racism and the COVID-19 experience in the United States.
• Root cause analysis to identify contributing factors for the development of hospital acquired pressure injuries.
• Errors in breast imaging: how to reduce errors and promote a safety environment.

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).

Better Patient Care Experiences Positively Impact Business Outcomes

Investments in patient experience are associated with improved business outcomes, according to AHRQ-funded researchers who conducted the first literature review on the topic. Patients who reported positive care experiences were more likely to return to the same hospital or ambulatory setting for future healthcare needs, retain their health plan and voice fewer complaints, according to the review. Access the abstract of the review published in the Journal of Healthcare Management.

AHRQ in the Professional Literature

Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses. Adams V, Song J, Shang J, et al. Am J Infect Control 2021 Jun;49(6):721-6. Epub 2020 Nov 4. Access the abstract on PubMed®.

Association between missed doses of chemoprophylaxis and VTE incidence in a statewide colectomy cohort. Khorfan R, Kreutzer L, Love R, et al. Ann Surg 2021 Apr;273(4):e151-2. Access the abstract on PubMed®.

Incidence, duration and risk factors associated with delayed and missed diagnostic opportunities related to tuberculosis: a population-based longitudinal study. Miller AC, Arakkal AT, Koeneman S, et al. BMJ Open 2021 Feb 18;11(2):e045605. Access the abstract on PubMed®.

Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings. Nair D, Malhotra S, Lupu D, et al. Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-7. Access the abstract on PubMed®.

Implementation strategies in the context of medication reconciliation: a qualitative study. Stolldorf DP, Ridner SH, Vogus TJ, et al. Implement Sci Commun 2021 Jun 10;2(1):63. Access the abstract on PubMed®.

Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults. Campbell NL, Holden RJ, Tang Q, et al. J Am Geriatr Soc 2021 Jun;69(6):1490-9. Epub 2021 Mar 26. Access the abstract on PubMed®.

Racial and ethnic differences in managed care enrollment among US children. Peltz A, Kan K, Garg A, et al. JAMA Netw Open 2021 Apr;4(4):e214162. Epub 2021 Apr 2. Access the abstract on PubMed®.

Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members. MacEwan SR, Gaughan A, Hefner JL, et al. Patient Educ Couns 2021 Apr;104(4):836-43. Epub 2020 Sep 23. Access the abstract on PubMed®.