Study Finds Significant Racial Disparities in Pediatric Mental Health Rehospitalizations

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Access more data on this topic in the associated statistical brief, plus additional AHRQ data infographics.

Today's Headlines:

• Study Finds Significant Racial Disparities in Pediatric Mental Health Rehospitalizations.
• Dedicated COVID-19 Unit Improves Testing Follow-Up.
• Grantee Profile Highlights Work of David Newman-Toker, M.D., Ph.D., To Improve Accuracy of Stroke Diagnosis.
• Highlights From AHRQ’s Patient Safety Network
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

Study Finds Significant Racial Disparities in Pediatric Mental Health Rehospitalizations

Understanding and mitigating social determinants of health, such as insurance coverage, household income and residence in a rural area could improve equity in the treatment of children with mental health conditions, according to an AHRQ-supported study published in the Journal of Pediatrics. Researchers analyzed more than 23,000 hospitalizations for children aged 5 to 18 years from 2016 to 2018 at 32 freestanding U.S. children’s hospitals to determine which children were more likely to be readmitted for mental health conditions. Of 1,382 90-day mental health rehospitalizations, researchers found that non-Hispanic Black children were 26 percent more likely to be rehospitalized for mental health conditions to acute care non-psychiatric children’s hospitals within 90 days than non-Hispanic white children. Children with government insurance were 18 percent more likely to be rehospitalized than those with private insurance. Those living in a suburb were 22 percent less likely to be rehospitalized than those living in an urban location. Researchers conclude that future efforts should work on upstream interventions that will address social disparities to promote equity in pediatric mental healthcare. Access the abstract.

Dedicated COVID-19 Unit Improves Testing Follow-Up

A dedicated ambulatory unit for patients with known or suspected COVID-19 exposure consistently completed over 85 percent of requested follow-ups within 24 hours, according to an AHRQ-funded study in The Journal of Ambulatory Care Management Utilizing a systems engineering methodology, Beth Israel Deaconess Medical Center established an Ambulatory Respiratory Cohorted Care Unit with dedicated space, staff and clinicians and implemented 100 percent paperless ordering and manually scheduled follow-ups. Nearly every patient with suspected COVID-19 seen by this unit received a test on the same day they were triaged and returned the following day for their results. However, in interviews, staff and patients expressed ongoing confusion regarding their roles, challenges identifying infections from a broad range of symptoms and patients’ unwillingness to attend in-person appointments, indicating a need for further refinements. Access the abstract.

Grantee Profile Highlights Work of David Newman-Toker, M.D., Ph.D., To Improve Accuracy of Stroke Diagnosis

Dizziness is a common symptom that brings about 5 million patients to U.S. hospital emergency departments (EDs) each year. Identifying who may have a serious—even life-threatening—underlying cause such as stroke has been a key research goal of David Newman-Toker, M.D., Ph.D., professor of neurology, ophthalmology and otolaryngology at Johns Hopkins University, Baltimore. The subject of a new AHRQ grantee profile, Dr. Newman-Toker is developing a performance measure to assess hospitals’ track record on accurate stroke diagnosis in collaboration with the American College of Emergency Physicians and the Society to Improve Diagnosis in Medicine. Access Dr. Newman-Toker’s profile as well as additional AHRQ profiles.

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:

• It's like sending a message in a bottle: a qualitative study of the consequences of one-way communication technologies in hospitals.
• The efficacy of mindful practice in improving diagnosis in healthcare: a systematic review and evidence synthesis.
• Acute care nurses' perceptions of leadership, teamwork, turnover intention and patient safety—mixed methods study.

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).

New Research and Evidence From AHRQ

• Systematic Review: Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury.

AHRQ in the Professional Literature

Toward an asthma patient-reported outcome measure for use in digital remote monitoring. Rudin RS, Qureshi N, Foer D, et al. J Asthma 2021 Jul 29. [Epub ahead of print.] Access the abstract on PubMed®.

Using standardized videos to examine the validity of the shared decision making process scale: results of a randomized online experiment. Valentine KD, Mancini B, Vo H, et al. Med Decis Making 2021 Aug 3. [Epub ahead of print.] Access the abstract on PubMed®.

Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States. Tzeng HM, Raji MA, Chou LN, et al. J Nurs Care Qual 2021 Sep 3. [Epub ahead of print.] Access the abstract on PubMed®.

Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study. Dowding D, Russell D, Trifilio M, et al. Int J Nurs Stud 2020 Jul;107:103617. Epub 2020 May 8. Access the abstract on PubMed®.

National trends In ED visits, hospital admissions, and mortality for Medicare patients during the COVID-19 pandemic. Smulowitz PB, O'Malley AJ, Khidir H, et al. Health Aff 2021 Sep;40(9):1457-64. Access the abstract on PubMed®.

Designing a patient room as a fall protection strategy: the perspectives of healthcare design experts. Piatkowski M, Taylor E, Wong B, et al. Int J Environ Res Public Health 2021 Aug 19;18(16):8769. Access the abstract on PubMed®.

Unmet family caregiver training needs associated with acute care utilization during home health care. Burgdorf JG, Arbaje AI, Stuart EA, et al. J Am Geriatr Soc 2021 Jul;69(7):1887-95. Epub 2021 Mar 26. Access the abstract on PubMed®.

Diagnostic errors in pediatric critical care: a systematic review. Cifra CL, Custer JW, Singh H, et al. Pediatr Crit Care Med 2021 Aug;22(8):701-12. Access the abstract on PubMed®.