December 20, 2012
Nearly one in five heart attack patients are readmitted within 30 days of discharge for another heart attack, heart failure, shock, a cardiac procedure, infections, gastrointestinal hemorrhage, or other conditions. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #140: Readmissions for Heart Attack, 2009]
- More research is needed to compare therapies for colorectal cancer metastasis to the liver.
- New review assesses research on evaluation and treatment for undescended testicles.
- AHRQ report assesses use of Medicaid home and community-based services.
- AHRQ's Health Care Innovations Exchange focuses on reducing health disparities among children.
- 2010 Nationwide Emergency Department Sample database now available.
- AHRQ in the professional literature.
1. More Research Is Needed To Compare Therapies for Colorectal Cancer Metastasis to the Liver
Insufficient evidence exists to compare the effectiveness of local hepatic therapies for patients with liver metastases caused by colorectal cancer and for whom surgery is not an option. The therapies described in the new AHRQ review that target the liver include ablation (destruction of tissue by heating or cooling), embolization (blocking blood vessels that feed the cancer), and radiotherapy (directed radiation to destroy cancer cells). Extensive gaps in the research and the quality of available studies prevent researchers from comparing the effectiveness of these treatments and from determining their benefits or harms. A patient registry may generate ideas for clinical trials that can further test the effectiveness of these therapies. Select to access these findings in the full review, Local Hepatic Therapies for Metastases to the Liver from Unresectable Colorectal Cancer: Effectiveness and Comparative Effectiveness.
2. New Review Assesses Research on Evaluation and Treatment for Undescended Testicles
Both laparoscopic and open surgical techniques are effective for moving undescended testicles to a normal position in the scrotum, according to a new AHRQ review of research on evaluation and treatment of this condition. However, no specific imaging technique is able to consistently determine the presence or absence of testicles or the location of undescended testicles, the review found. Insufficient evidence exists to evaluate if hormonal stimulation testing can determine the absence of testicles. Additional studies comparing various imaging techniques are needed to determine which techniques produce the best results and eliminate the need for surgical evaluation. Future studies should also seek to identify the appropriate age for treatment and which types of patients would benefit from hormonal treatment for undescended testicles. Select to access these findings in the full review, Evaluation and Treatment of Cryptorchidism.
3. AHRQ Report Assesses Use of Medicaid Home and Community-based Services
One of every 25 Medicaid patients, or about 2.2 million people, received home health care and other community-based services in 2005, according to a new AHRQ report. It includes findings for the availability and use of home and community-based services and potentially avoidable hospital admission rates. Select to access the report, Health and Welfare of the Medicaid Home and Community-Based Services Population. Select for a related report, Development of Quality Indicators for the Home and Community-Based Services Population: Technical Report [PDF file, Plugin Software Help]. The researchers also published "Users of Medicaid Home and Community-Based Services Are Especially Vulnerable to Costly Avoidable Hospital Admissions" in the June 2012 issue of Health Affairs. Select to access the abstract on PubMed®.
4. AHRQ's Health Care Innovations Exchange Focuses on Reducing Health Disparities Among Children
The December 19 issue of AHRQ's Health Care Innovations Exchange profiles efforts to reduce health disparities among children. Profiles describe a program that provided culturally competent asthma care to Latino families, a State policy that increased access to Medicaid coverage for uninsured children, and a medical center's use of text messaging to increase vaccination rates among low-income minority children. In Louisiana, an initiative known as Express Lane Eligibility, uses a data-matching program to automatically enroll qualified low-income children in Medicaid based on information submitted to the State's Supplemental Nutrition Assistance Program. As a result, low-income children, hard-to-enroll populations, and those with inadequate coverage have access to a wide range of health care services. The program has also significantly reduced the number of uninsured children in the State and has lowered administrative costs for the Louisiana Medicaid program. View more innovation profiles and tools related to children's health disparities on the Innovations Exchange Web site, which contains more than 750 searchable innovations and 1,500 QualityTools.
5. 2010 Nationwide Emergency Department Sample Database Now Available
The 2010 Nationwide Emergency Department Sample (NEDS) is now available. With national estimates of emergency department (ED) visits, the NEDS is the largest all-payer ED database in the United States and contains information about geographic, hospital, patient, and visit characteristics. It is one of the databases in the family of products generated by the Healthcare Cost and Utilization Project (HCUP). Aggregated statistics from the 2010 NEDS can be accessed via HCUPnet, the free, online query system that uses HCUP data. A trends query for the NEDS was added to HCUPnet, providing national trends on stays and diagnoses from 2006 to 2010. The 2010 NEDS is available for purchase through the HCUP Central Distributor.
6. AHRQ in the Professional Literature
Anderson LH, Flottemesch TJ, Fontaine P, et al. Patient medical group continuity and healthcare utilization. Am J Manag Care 2012 Aug; 18(8):450-7. Select to access the abstract on PubMed®.
Glance LG, Osler TM, Mukamel DB, et al. Outcomes of adult trauma patients admitted to trauma centers in Pennsylvania, 2000-2009. Arch Surg 2012 Aug; 147(8):732-7. Select to access the abstract on PubMed®.
Spindler KP, Parker RD, Andrish JT, et al. Prognosis and predictors of ACL reconstructions using the MOON cohort: a model for comparative effectiveness studies. J Orthop Res 2012 Aug 21. [Epub ahead of print.] Select to access the abstract on PubMed®.
Bhanegaonkar A, Madhavan SS, Khanna R, et al. Declining mammography screening in a state Medicaid fee-for-service program: 1999-2008. J Womens Health 2012 Aug; 21(8):821-9. Select to access the abstract on PubMed®.
Price RC, Huth D, Smith J, et al. Federated queries for comparative effectiveness research: performance analysis. Stud Health Technol Inform 2012; 175:9-18. Select to access the abstract on PubMed®.
Burkholder GA, Tamhane AR, Salinas JL, et al. Underutilization of aspirin for primary prevention of cardiovascular disease among HIV-infected patients. Clin Infect Dis 2012 Aug 31. [Epub ahead of print.] Select to access the abstract on PubMed®.
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Current as of December 2012
AHRQ Electronic Newsletter, December 20, 2012, Issue 362. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews362.htm