Health Care Quality Slowly Improving, While Some Americans Still Lack Access

Electronic Newsletter, Issue 380

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

May 22, 2013

AHRQ Stats

Approximately 1.5 percent of emergency department visits resulted in transfer to another acute care facility. Transfer rates differed by the characteristics of patients and hospitals. Rates of transfer were highest for elderly patients, very young children, and people from rural areas. Non-trauma, non-teaching, and public hospitals had higher rates of transfer. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #155, Emergency Department Transfers to Acute Care Facilities, 2009).

Today's Headlines

  1. Health Care Quality Slowly Improving, While Some Americans Still Lack Access.
  2. AHRQ’s Health Care Innovations Exchange Focuses on Accountable Care Organizations.
  3. New Funding Opportunity Seeks Patient Centered Outcomes Research to Close Health Care Disparities.
  4. Limited Evidence on Best Approaches for Pressure Ulcer Treatment and Prevention, AHRQ Reviews Find.
  5. AHRQ to Demonstrate HCUP, MEPS at Health Datapalooza on June 3-4.
  6. Register for June 5 Web Event on Building Health Information Exchanges to Support ACOs and Medical Homes: Delaware’s Experience.
  7. Register for The People’s Scientific Conference to Promote Health and Eliminate Health Disparities on June 14-15.
  8. AHRQ in the professional literature.

 

1. Health Care Quality Slowly Improving, While Some Americans Still Lack Access

The quality of U.S. health care is slowly improving, while access to health care remains a great challenge for some Americans, especially racial and ethnic minorities and low-income people, according to AHRQ's 2012 National Healthcare Quality Report and National Healthcare Disparities Report. The new reports call for “urgent attention” on continuing improvements in the quality of diabetes care, maternal and child health care, and treatment for conditions such as pressure ulcers and blood clots. Included in this year's reports are new measures on early and adequate prenatal care, colorectal cancer screening, national rate of hospital-acquired conditions, standardized infection ratios at the state level for central line-associated bloodstream infections, and patient safety culture hospital survey findings. Quality and access data predate passage of the Affordable Care Act, which is addressing many of these issues. The reports are available online at http://www.ahrq.gov/research/findings/nhqrdr/index.html. To order a print copy, email ahrqpubs@ahrq.hhs.gov or call 1-800-358-9295.

2. AHRQ’s Health Care Innovations Exchange Focuses on Accountable Care Organizations

Two accountable care organizations (ACOs) that used financial risk sharing and various improvement initiatives to reduce health care utilization and costs for defined patient populations are featured by the AHRQ's Health Care Innovations Exchange. One profile describes a county-based accountable care organization that integrates medical, behavioral, and social services with the goal of improving outcomes and reducing costs for newly enrolled Medicaid beneficiaries in Hennepin County, Minn. Known as Hennepin Health, the ACO is a partnership among several entities within the county government that share financial risk. An assigned care coordinator works to ensure that each enrollee receives appropriate services based on his or her medical, mental, and social service needs. Partners share data electronically to generate complete information on each enrollee and jointly implement initiatives to improve care and promote appropriate utilization. The organization has seen higher enrollment; lowered admissions, readmissions, and emergency department visits; and high enrollee satisfaction. Access more innovation profiles and tools related to accountable care organizations on the Innovations Exchange Web site, which contains more than 775 searchable innovations and 1,525 Quality Tools.

3. New Funding Opportunity Seeks Patient Centered Outcomes Research to Close Health Care Disparities

AHRQ is soliciting Research Demonstration Cooperative Agreement applications from institutions to establish and engage relationships with diverse stakeholders to identify effective strategies to reduce racial and ethnic health care disparities through shared decision-making. Institutions also will demonstrate how to reduce disparities through the translation, dissemination, and implementation of Patient Centered Outcomes Research (PCOR) findings. This funding opportunity focuses on racial and ethnic minorities in underserved settings. Application deadline is July 31.

4. Limited Evidence on Best Approaches for Pressure Ulcer Treatment and Prevention, AHRQ Reviews Find

Limited evidence is available to draw firm conclusions about the best approaches for treating pressure ulcers, a finding consistent with other recent reviews, according to a new research review from AHRQ's Effective Health Care Program. Given the serious impact pressure ulcers have on health status, costs, and patient quality of life, treatments are needed to promote and shorten healing and minimize the risk of complications. Some evidence suggests wound improvement (reduction in ulcer size) was better on air-fluidized beds compared to other support surfaces, including standard hospital beds. Nutritional supplementation also resulted in wound improvement when used with other measures for treating pressure ulcers. Advancing pressure ulcer care will take more rigorous studies to solidify the evidence base on widely used treatments. These findings can be found in the full review, Pressure Ulcer Treatment Strategies: Comparative Effectiveness. A related research report found that commonly used instruments to assess patients' risk of pressure ulcers can identify patients at increased risk for ulcers when compared with clinical judgment. Frequently used instruments include the Braden, Norton, and Waterlow scales. In higher risk populations, studies consistently found advanced static support mattresses and overlays were associated with lower risk of pressure ulcers compared with standard mattresses, with no clear differences between different advanced static support surfaces. More research is needed to understand the effectiveness of other preventive interventions in relation to standard care, and the comparative effectiveness of preventive interventions. These findings can be found in the full review, Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness.

5. AHRQ to Demonstrate HCUP, MEPS at Health Datapalooza on June 3-4

As a supporter of widespread use of health data to promote quality, efficiency, and effectiveness, AHRQ will participate in the fourth annual Health Datapalooza conference, to be held on June 3-4 in Washington, D.C. The conference features new and innovative uses of health data by individuals, academic organizations, private and non-profit companies, start-ups and government agencies. AHRQ will demonstrate the latest applications of its two powerful health databases, the Healthcare Cost and Utilization Project (HCUP) and the Medical Expenditure Panel Survey (MEPS). HCUP is the largest collection of longitudinal hospital care data in the United States, representing 97 percent of all inpatient hospital discharges. MEPS is the most complete source of U. S. data on the cost and use of health care services and insurance coverage, obtained through large-scale, annual surveys of families, individuals, medical providers and employers. AHRQ is a member of the Health Data Consortium, the event's organizer, and a collaborative of government, non-profit and private organizations that advocates data best practices and information sharing. Select to register for the conference.

6. Register for June 5 Web Event on Building Health Information Exchanges to Support ACOs and Medical Homes: Delaware's Experience

Join the AHRQ Health Care Innovations Exchange on June 5 from 1:00 to 2:00 p.m. EDT for an interactive dialogue exploring strategies for building health information exchanges to promote accountable care organizations (ACOs) and patient-centered medical homes (PCMHs). The webinar is the third in a series designed to share novel experiences and lessons learned in putting ACO/PCMH principles into practice. Learn how Delaware's innovative Health Information Network, an integrated, statewide health data system, supports the information needs of consumers, health plans, policymakers, providers, purchasers and research to improve the quality and efficiency of health care services. Select to register for the Web event.

7. Register for The People's Scientific Conference to Promote Health and Eliminate Health Disparities on June 14-15

The People's Scientific Conference to Promote Health and Eliminate Health Disparities, to be held at the University of Florida at Gainesville on June 14-15, will feature presentations by nationally known medical and research experts on common health problems among racial and ethnic minority, low-income, and other underserved communities. The conference is sponsored by the University of Florida Health Disparities Research and Intervention Program in partnership with the University of Florida Prostate Disease Center and the National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health. Select to register for the conference and to get additional information. Registration is required by June 10.

8. AHRQ in the Professional Literature

Chang JC, Alexander SC, Holland CL, et al. Smoking is bad for babies: obstetric care providers' use of best practice smoking cessation counseling techniques. Am J Health Promot 2013 Jan-Feb; 27(3):170-6. Select to access the abstract on PubMed.®

Morgan DJ, Pineles L, Shardell M, et al. The effect of contact precautions on healthcare worker activity in acute care hospitals. Infect Control Hosp Epidemiol 2013 Jan; 34(1):69-73. Select to access the abstract on PubMed.®

Marsolo K. Informatics and operations—let's get integrated. J Am Med Inform Assoc 2013 Jan; 20(1):122-4. Select to access the abstract on PubMed.®

Welch S, Savitz L. Exploring strategies to improve emergency department intake. J Emerg Med 2012 Jul; 43(1):149-58. Select to access the abstract on PubMed.®

Boult C, Leff B, Boyd CM, et al. A matched-pair cluster-randomized trial of guided care for high-risk older patients. J Gen Intern Med 2013 Jan 10. Select to access the abstract on PubMed.®

Porter J, Feinglass J, Artz N, et al. Sickle cell disease patients' perceptions of emergency department pain management. J Natl Med Assoc 2012 Sep-Oct; 104(9-10):449-54. Select to access the abstract on PubMed.®

Burton AM, Sautter JM, Tulsky JA, et al. Burden and well-being among a diverse sample of cancer, congestive heart failure, and chronic obstructive pulmonary disease caregivers. J Pain Symptom Manage 2012 Sep; 44(3):410-20. Select to access the abstract on PubMed.®

Reardon JM, Valenzuela JE, Parmar S, Venkatesh AK, Schuur JD, et al. The time burden of alcohol-based hand cleanser when using nonsterile gloves. Infect Control Hosp Epidemiol 2013 Jan; 34(1):96-8. Select to access the abstract on PubMed.®

Contact Information

Please address comments and questions about the AHRQ Electronic Newsletter to Linwood Norman at: Linwood.Norman@ahrq.hhs.gov or (301) 427-1248.

Update your subscriptions, modify your password or Email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your E-mail address to log in.

If you have any questions or problems with the subscription service, Email: updates@subscriptions.ahrq.gov. For other inquiries, Contact Us.

If you have questions about AHRQ's activities, please try to find the answers by checking our Home Page, where we have established links to various topical areas. Also check the News & Information section and Frequently Asked Questions. These features are designed to assist you in obtaining the information you are seeking.

This service is provided to you at no charge by the Agency for Healthcare Research and Quality AHRQ).

Page last reviewed May 2013
Internet Citation: Health Care Quality Slowly Improving, While Some Americans Still Lack Access: Electronic Newsletter, Issue 380. May 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/380.html