Higher Opioid Doses Prescribed for White Patients than Black Patients

Editor’s Note: AHRQ News Now will not publish next week.

AHRQ Stats: Highest Hospital Readmission Rate

Hospital admissions due to sickle cell trait/anemia had the highest readmission rate within 30 days in 2018, representing more than one in three adult hospitalizations (36 percent). (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #278: Overview of Clinical Conditions With Frequent and Costly Hospital Readmissions by Payer, 2018.)

Today's Headlines:

• Higher Opioid Doses Prescribed for White Patients than Black Patients.
• AHRQ Views Blog: Investing in Primary Care to Ensure High-Quality Care for All Americans.
• Featured Studies on the Nation's Health Systems.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Higher Opioid Doses Prescribed for White Patients than Black Patients

Black and White patients received markedly different opioid doses within individual health systems, an AHRQ-funded study published in The New England Journal of Medicine found. While the annual rate of opioid prescription receipt among 600,000 Black and White Medicare patients at 310 health systems was similar, the average annual opioid dose prescribed to White patients by health systems was 36 percent higher than the average dose prescribed to Black patients. Given no evidence of race differences in perception or pain management preferences, the authors called for further research to investigate why Black and White patients received different opioid dosages, including clinician’s potential conscious and unconscious racial bias. Access the abstract.

AHRQ Views Blog: Investing in Primary Care to Ensure High-Quality Care for All Americans

AHRQ will build on past successes as the foundation of new efforts to answer critical questions needed to deliver high-quality primary care. In a new AHRQ Views blog post, Arlene Bierman, M.D., director of AHRQ’s Center for Evidence and Practice Improvement, and Bob McNellis, M.P.H., AHRQ’s senior advisor for primary care, discuss how the momentum for greater interest and investments in primary care and primary care research will allow AHRQ to achieve important impacts on everyday practice. AHRQ’s efforts will be informed by two reports—one by the RAND Corporation and another by the National Academies of Sciences, Engineering and Medicine—that have provided a roadmap for enabling primary care to achieve its potential. In addition, the President’s FY22 budget proposal includes robust endorsements for this work for the first time in many years. AHRQ’s past, present and future primary care research can help guide primary care’s recovery and adaptations to the ever-evolving COVID-19 pandemic and address future challenges to the nation’s healthcare. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

Featured Studies on the Nation's Health Systems

AHRQ's Comparative Health System Performance Initiative funds studies about how healthcare delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Publications include:

• Soft Consolidation in Medicare ACOs: Potential for Higher Prices Without Mergers or Acquisitions.
• Physician practices in Accountable Care Organizations are more likely to collect and use physician performance information, yet base only a small proportion of compensation on performance data.
• The Role of Value-Based Payment in Promoting Innovation to Address Social Risks: A Cross-Sectional Study of Social Risk Screening by US Physicians.

Access the initiative's Compendium of U.S. Health Systems, 2018, the first publicly available database that gives researchers, policymakers and healthcare administrators a snapshot of the nation's health systems.

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:

• Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: a mixed-methods study.
• Improving medication reconciliation with comprehensive evaluation at a Veterans Affairs skilled-nursing facility.
• Patient-safety incidents during COVID-19 health crisis in France: An exploratory sequential multi-method study in primary care.

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).

AHRQ in the Professional Literature

Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review. Adams LB, Richmond J, Watson SN, et al. Health Educ Behav 2021 Aug;48(4):516-31. Epub 2020 Oct 14. Access the abstract on PubMed®.

Development and evaluation of the shared decision making process scale: a short patient-reported measure. Valentine KD, Vo H, Fowler FJ, Jr., et al. Med Decis Making 2021 Feb;41(2):108-19. Epub 2020 Dec 15. Access the abstract on PubMed®.

Development and validation of a model to predict pediatric septic shock using data known 2 hours after hospital arrival. Scott HF, Colborn KL, Sevick CJ, et al. Pediatr Crit Care Med 2021 Jan;22(1):16-26. Access the abstract on PubMed®.

Race and gender disparities in access to parathyroidectomy: a need to change processes for diagnosis and referral to surgeons. Mallick R, Xie R, Kirklin JK, et al. Ann Surg Oncol 2021 Jan;28(1):476-83. Epub 2020 Jun 15. Access the abstract on PubMed®.

Risk factors associated with medication ordering errors. Abraham J, Galanter WL, Touchette D, et al. J Am Med Inform Assoc 2021 Jan 15;28(1):86-94. Access the abstract on PubMed®.

Association of Medicaid expansion with quality in safety-net hospitals. Chatterjee P, Qi M, Werner RM. JAMA Intern Med 2021 May;181(5):590-7. Epub 2021 Feb 15. Access the abstract on PubMed®.

Care-partner support and hospitalization in assisted living during transitional home health care. Wang J, Ying M, Temkin-Greener H, et al. J Am Geriatr Soc 2021 May;69(5):1231-9. Epub 2021 Jan 4. Access the abstract on PubMed®.

Association between 30-day readmission rates and health information technology capabilities in US hospitals. Elysee G, Yu H, Herrin J, et al. Medicine 2021 Feb 26;100(8):e24755. Access the abstract on PubMed®.