Admission Rates from Emergency Departments Vary Widely

Electronic Newsletter, Issue 368

AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.

February 19, 2013

AHRQ Stats

Medical care spending to treat adults for heart disease totaled nearly $96 billion in 2009, with hospital stays accounting for more than half the cost. (Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #393, Expenditures for Heart Disease among Adults Age 18 and Older: Estimates for the U.S. Civilian Noninstitutionalized Population, 2009.)

Today's Headlines

  1. Admission Rates from Emergency Departments Vary Widely.
  2. AHRQ Seeks Applications to Inform the Development of Health IT Meaningful Use Objectives.
  3. Hybrid Data Sets Can Improve Hospital Quality Reporting.
  4. National Quality Strategy Offers Free Communications Toolkit.
  5. Customized Software Tool Helps Pre-Pregnancy Education in Minority Women.
  6. 2012 Guide to Clinical Preventive Services Now Available.
  7. Automation of the Medication Regimen May Improve Compliance.
  8. Register for April 25-26 Conference on "Health Disparities Research at the Intersection of Race, Ethnicity, and Disability".
  9. AHRQ in the professional literature. 

1. Admission Rates from Emergency Departments Vary Widely

A new study in the January 6 issue of Medical Care and Research Review found a greater than 2.5-fold variation in the admission rate from the emergency department in a sample of hospitals across 28 States. This indicates wide variation in a costly, everyday decision that will require further study, in light of the major impact that hospital admissions play in rising health care costs, according to the study authors from AHRQ and George Washington University. For-profit hospitals, trauma centers, and hospitals with higher proportions of Medicare and uninsured patients had higher admission rates. Also, local practice patterns and availability of primary care doctors were important factors. Fewer primary care doctors were associated with higher admission rates, while some admissions decisions were influenced by local care standards. Select to access the abstract on PubMed®. 

2. AHRQ Seeks Applications to Inform the Development of Health IT Meaningful Use Objectives

AHRQ is seeking applications for research demonstration projects that will provide evidence to inform the development of meaningful use objectives. Projects of interest include those that evaluate implementation of proposed Stage 3 meaningful use objectives in primary care practices for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and that propose strategies for improving the objectives at the policy level, EHR innovations that would support meeting the proposed objectives, and suggestions for primary care practices to increase the value of meaningful use objectives. Other projects of interest include those that evaluate implementation of the same objectives and propose similar strategies for improvement in the hospital setting. These projects must begin by September 2013, and disseminate results before June 2014. Select to access information about submitting applications by the March 28 application receipt date. Select for additional information. 

3. Hybrid Data Sets Can Improve Hospital Quality Reporting

A hybrid data set that combines clinical laboratory data with administrative claims improved the measurement of risk-adjusted hospital performance, according to an AHRQ-funded pilot project conducted by the Minnesota Hospital Association. In addition, the hybrid data set improved the ability to compare risk-adjusted mortality and complications across the 13 Minnesota hospitals where the project was conducted. The report, "Harnessing the Power of Enhanced Data for Healthcare Quality Improvement: Lessons from a Minnesota Hospital Association Pilot Project," provides recommendations on how to collect hybrid data sets. It was published in the November/December 2012 issue of the Journal of Healthcare Management. Select to access the abstract on PubMed®. 

4. National Quality Strategy Offers Free Communications Toolkit

The National Quality Strategy (NQS), called for in the Affordable Care Act and led by HHS in cooperation with AHRQ, is offering a new toolkit to support the activities of private and public organizations in advancing its mission. The toolkit contains links to factsheets that can be printed and distributed, blogs and social media announcements and a briefing slide set. Organizations can use these materials to develop messages that align with NQS aims and priorities. Select to access the NQS toolkit. 

5. Customized Software Tool Helps Pre-Pregnancy Education in Minority Women

Customized education from a software tool may help women of childbearing age understand pre-pregnancy health, according to AHRQ-supported research. The study, "Reaching Women Through Health Information Technology: The Gabby Preconception Care System," which appeared in the January/February edition of the American Journal of Health Promotion, evaluated the effectiveness of a software program designed to increase minority women's awareness of health before pregnancy. The study used an animated character named "Gabby," who asked questions that educated women about their risks and identified healthier choices. Based on their responses, a "to do" list was generated. The women followed up on more than 80 percent of the issues that they had identified on their lists. Select to access abstract on PubMed®. 

6. 2012 Guide to Clinical Preventive Services Now Available

The 2012 Guide to Clinical Preventive Services, which includes updated recommendations from the U.S. Preventive Services Task Force on clinical preventive services such as screening, counseling, and preventive medications from 2002 through March 2012, is now available. This edition also includes information on topics in development, background about the Task Force, at-a-glance clinical summary tables, and additional resources. Select to access the Guide to Clinical Preventive Services, 2012. 

7. Automation of the Medication Regimen May Improve Compliance

Difficulties in taking medicines are impacted by more than just the number of pills patients take, according to a new AHRQ-supported study. How often a medication is taken, whether the dose is always the same, and whether the medicine it is administered by mouth, through a shot, or through a patch, all have an impact on patients' ability to follow their doctors' or nurses' instructions. Researchers had previously developed a medication regimen complexity index (MRCI) to help health care teams calculate the difficulty of their patients' medicine schedules. A recent study suggests that researchers may be able to use computers to automatically tabulate the difficulty of following medication instructions. Automated calculations would allow health care teams to identify patients who are at higher risk of adverse events and could potentially be used to improve medication management and patient outcomes. Select to access the study , "Automating the Medication Regimen Complexity Index", published online December 25, 2012 in the Journal of the American Medical Informatics Association. 

8. Register for April 25-26 Conference on "Health Disparities Research at the Intersection of Race, Ethnicity, and Disability"

An AHRQ-sponsored national conference, to be held April 25-26 in Washington, D.C., will bring together researchers, advocates, and policy-makers in racial, ethnic, and disability-related disparities. Attendees will learn about barriers to health care and health promotion for people with disabilities in underserved racial and ethnic groups, share research work on the intersection of racial/ethnic disparities and disabilities, and discuss priorities for future research and action. The conference is sponsored by AHRQ, the Association of University Centers on Disabilities, and the Special Hope Foundation. Select to register for the conference. 

9. AHRQ in the Professional Literature

LaPar DJ, Kron IL, Jones DR, Stukenborg GJ, Kozower BD. Hospital procedure volume should not be used as a measure of surgical quality. Ann Surg 2012 Oct; 256(4):606-15. Select to access the abstract on PubMed®.

Fishman PA, Johnson EA, Coleman K, et al. Impact on seniors of the patient-centered medical home: evidence from a pilot study. Gerontologist 2012 Oct; 52(5):703-11. Select to access the abstract on PubMed®.

Zhou C, Zhang Y. The vast majority of Medicare Part D beneficiaries still don't choose the cheapest plans that meet their medication needs. Health Aff 2012 Oct; 31(10):2259-65. Select to access the abstract on PubMed®.

Virtanen M, Oksanen T, Kawachi I, et al. Organizational justice in primary-care health centers and glycemic control in patients with type 2 diabetes. Med Care 2012 Oct; 50(10):831-5. Select to access the abstract on PubMed®.

Kundrapu S, Sunkesula V, Jury LA, Sitzlar BM, Donskey CJ. Daily disinfection of high-touch surfaces in isolation rooms to reduce contamination of healthcare workers' hands. Infect Control Hosp Epidemiol 2012 Oct; 33(10):1039-42. Select to access the abstract on PubMed®.

Laxmisan A, Sittig DF, Pietz K, et al. Effectiveness of an electronic health record-based intervention to improve follow-up of abnormal pathology results: a retrospective record analysis. Med Care 2012 Oct; 50(10):898-904. Select to access the abstract on PubMed®.

Holden RJ. Social and personal normative influences on healthcare professionals to use information technology: towards a more robust social ergonomics. Theor Issues Ergon 2012 Sep 1; 13(5):546-69. Select to access the abstract on PubMed®.

Barocas DA, Gray DT, Fowke JH, et al. Racial variation in the quality of surgical care for prostate cancer. J Urol 2012 Oct; 188(4):1279-85. Select to access the abstract on PubMed®.

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Page last reviewed February 2013
Internet Citation: Admission Rates from Emergency Departments Vary Widely: Electronic Newsletter, Issue 368. February 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/368.html