AHRQ Views Blog Post: 2021—An AHRQ Year in Review

AHRQ Stats: Treat-and-Release Emergency Department Visits

Of 14 million emergency department (ED) visits in 2018, 86 percent were treated and released from the ED. Abdominal pain, acute upper respiratory infections and nonspecific chest pain were the most common reasons for treat-and-release ED visits. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #286, Most Frequent Reasons for Emergency Department Visits, 2018 [PDF, 919 KB].)

Today's Headlines:

• AHRQ Views Blog Post: 2021—An AHRQ Year in Review.
• AHRQ Grantee Advances Management Practices That Improve Care Quality, Safety.
• AHRQ Releases Annual Update on U.S. Healthcare Quality, Disparities.
• Veterans’ Race, Ethnicity and Age Among Factors Associated With Likelihood of Low-Value Cancer Screening.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ’s Medical Expenditure Panel Survey Procedures Adapted to COVID-19 Shutdowns.
• AHRQ in the Professional Literature.

AHRQ Views Blog Post: 2021—An AHRQ Year in Review

AHRQ’s 2021 accomplishments and the agency’s goals for the coming year are highlighted in a new blog post by David Meyers, M.D., AHRQ’s acting director. Topping agency achievements in 2021 were ongoing investments in health services research grants, including $17 million to explore healthcare delivery during the COVID-19 pandemic. Among other successes: free training for nursing home staff and residents to keep safe from COVID-19; ongoing efforts to reduce antibiotic use across clinical settings; new analyses of hospital data to help inform the nation’s response to public health emergencies; and emerging efforts to support the Biden-Harris administration’s goals related to increasing health equity and building the healthcare system’s resilience to climate change. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

AHRQ Grantee Advances Management Practices That Improve Care Quality, Safety

AHRQ grantee Ann Scheck McAlearney, Sc.D., M.S., is improving the quality and safety of healthcare by researching evidence-based management practices for clinical use. An associate dean for health services research and distinguished professor in the department of family and community medicine at The Ohio State University College of Medicine, Dr. McAlearney is studying effective evidence-based management practices in health information technology implementation and use. She is also focusing on care aimed at the prevention and reduction of healthcare-associated infections. As principal investigator for an AHRQ-funded Patient Safety Learning Laboratory, she improved the flow of hospital information to reduce distractions for clinicians. Access Dr. McAlearney’s profile and the profiles of other AHRQ grantees.

AHRQ Releases Annual Update on U.S. Healthcare Quality, Disparities

AHRQ has released its 2021 National Healthcare Quality and Disparities Report, which details the state of healthcare quality and disparities in the United States. The report identifies improvements in HIV and colon cancer care, nursing home care and medication prescribing to older adults. The report also indicates that more work needs to be done to address disparities in important areas. Among the findings:

• The numbers of people covered by health insurance and those who have a usual source of healthcare have increased significantly.
• Personal spending on health insurance and healthcare services decreased for people under age 65 with public insurance and increased for people with private insurance.
• Access to dental care and oral healthcare services remains low and has not substantially improved, particularly for people with low income or who live in rural areas.
• A multiyear rise in opioid-related hospitalizations had been tapering off prior to the COVID-19 pandemic, but the opioid crisis has worsened markedly since then. Suicide death rates were rising in all groups for more than a decade before the pandemic. Since then, suicide deaths have decreased in White populations but continue to rise in racial and ethnic minority populations. Limited access to substance abuse and mental health treatment may have contributed to these crises.
• While Black, Hispanic and American Indian and Alaska Native communities have experienced substantial improvements in healthcare quality, significant disparities in all domains of healthcare quality persist. Even when rates of improvement in quality exceeded those experienced by White Americans, the improvements have not been enough to eliminate disparities.

Veterans’ Race, Ethnicity and Age Among Factors Associated With Likelihood of Low-Value Cancer Screening

Low-value breast, cervical and colorectal cancer screenings were rare among patients seeking care from the Veterans Health Administration (VHA), but more than one-third of patients screened for prostate cancer received low-value tests outside of clinical practice guidelines, according to research supported by AHRQ. Cancer screenings may be regarded as low value if they are not expected to increase life expectancy or if potential harm outweighs benefits. The research, led by an AHRQ grantee, also found that veterans’ race, ethnicity and illness burden were significantly associated with the likelihood of receiving low-value prostate cancer screenings. Using 2019 to 2021 administrative data from VHA clinics to assess screening among nearly 6 million veterans, researchers found that less than 3 percent of cancer screening recipients received a low-value test for breast, cervical or colorectal cancer, but 39 percent of men screened for prostate cancer received a low-value test. Access the abstract of the study published in JAMA Network Open.

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:

• Association of differences in treatment intensification, missed visits, and scheduled follow-up interval with racial or ethnic disparities in blood pressure control.
• Association of surgeon-patient sex concordance with postoperative outcomes.
• Next of kin involvement in regulatory investigations of adverse events that caused patient death: a process evaluation.

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’s Medical Expenditure Panel Survey Procedures Adapted to COVID-19 Shutdowns

AHRQ researchers discuss changes to the Medical Expenditure Panel Survey (MEPS) necessitated by COVID-19 in a new commentary published in The American Journal of Public Health. Pandemic shutdowns required replacing MEPS Household Component (MEPS-HC) in-person interviews and MEPS Medical Care Provider (MEPS-MPC) and Insurance Component (MEPS-IC) call centers with remote, home-based outreach. Response rates across all three MEPS survey components fell to varying degrees. Initial reviews of 2020 data indicated no serious reduction in quality beyond reduced response rates.  Alongside a decision to extend MEPS-HC panels from 2018 and 2019 by 2 years, the surveys now include additional telehealth and COVID-19 specific items. Access the abstract.

AHRQ in the Professional Literature

Hidden dangers: recognizing excipients as potential causes of drug and vaccine hypersensitivity reactions. Caballero ML, Krantz MS, Quirce S, et al. J Allergy Clin Immunol Pract 2021 Aug;9(8):2968-82. Epub 2021 Mar 15. Access the abstract on PubMed®.

An academic hospital experience screening mRNA COVID-19 vaccine risk using patient allergy history. Krantz MS, Stone CA, Jr., Rolando LA, et al. J Allergy Clin Immunol Pract 2021 Oct;9(10):3807-10. Epub 2021 Jul 19. Access the abstract on PubMed®.

Managing organizational constraints in innovation teams: a qualitative study across four health systems. Atkinson MK, Singer SJ. Med Care Res Rev 2021 Oct;78(5):521-36. Epub 2020 June 17. Access the abstract on PubMed®.

Community social determinants and health outcomes drive availability of patient-centered medical homes. Bell N, Wilkerson R, Mayfield-Smith K, et al. Health Place 2021 Jan;67:102439. Epub 2020 Nov 16. Access the abstract on PubMed®.

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients. Naderi R, Oberndorfer TA, Jordan SR, et al. BMC Med Educ 2021 Jun 3;21(1):314. Access the abstract on PubMed®.

Using CAHPS patient experience data for patient-centered medical home transformation. Quigley DD, Qureshi N, AlMasarweh L, et al. Am J Manag Care 2021 Sep;27(9):e322-e9. Access the abstract on PubMed®.

Physiologic monitor alarm burden and nurses' subjective workload in a children's hospital. Rasooly IR, Kern-Goldberger AS, Xiao R, et al. Hosp Pediatr 2021 Jul;11(7):703-10. Epub 2021 Jun 1. Access the abstract on PubMed®.

Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study. Walunas TL, Ye J, Bannon J, et al. Implement Sci 2021 Mar 31;16(1):33. Access the abstract on PubMed®.