AHRQ Study Suggests New Metric for Assessing Care of Heart Failure Patients

Electronic Newsletter, Issue 393

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

August 27, 2013


AHRQ Stats

Individuals age 50 and older with heart disease were more than twice as likely as those without to have either a hospital stay or an emergency room visit in 2010, and they had average annual health expenditures that were a little more than double the average for individuals without a diagnosis of heart disease. (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief #408, Heart Disease among Near Elderly Americans: Estimates for the U.S. Civilian Noninstitutionalized Population, 2010, and Statistical Brief #409, Heart Disease among Elderly Americans: Estimates for the U.S. Civilian Noninstitutionalized Population, 2010.)

Today's Headlines

  1. AHRQ Study Suggests New Metric for Assessing Care of Heart Failure Patients.
  2. AHRQ Research Finds QRS Duration a Good Predictor of Who Will Benefit From a Pacemaker.
  3. AHRQ's "Questions Are the Answer" Offers Tools to Promote Patient Involvement .
  4. Register Now for August 29 AHRQ Webinar on Using EHR Data to Improve Care.
  5. Save the Date: AHRQ to Host Healthcare Cost and Utilization Project Webinars on Sept. 18 and 25.
  6. AHRQ Announces Health IT Career Development and Dissertation Research Grants.
  7. AHRQ's Patient Safety Network Offers Primer on Efforts to Prevent "Never Events".
  8. AHRQ in the professional literature.

1. AHRQ Study Suggests New Metric for Assessing Care of Heart Failure Patients

Total inpatient days during a 30-day episode of care may provide a more accurate measurement of health system quality, resource use, and outcomes than 30-day readmission rates, according to authors of an AHRQ-funded study. The researchers compared hospitals based on length of stay, total inpatient days for episodes of care (all clinically related services for a patient's condition from onset of symptoms until the completion of treatment, including readmissions within 30 days), and 30-day readmission rates for heart failure patients. The study, "Are We Targeting the Right Metric for Heart Failure? Comparison of Hospital 30-Day Readmission Rates and Total Episode of Care Inpatient Days," found that the 30-day readmission rate was poorly correlated with hospital length of stay, better performance on quality measures, or 30-day mortality risk. In contrast, the shorter episode of care metric was associated with better 30-day survival. The study was published in the April 6 online edition of the American Heart Journal. Select to access the abstract on PubMed®.

2. AHRQ Research Finds QRS Duration a Good Predictor of Who Will Benefit From a Pacemaker

New research from AHRQ's Effective Health Care Program finds that among fee-for-service Medicare beneficiaries undergoing cardiac resynchronization therapy defibrillator (CRT-D) implantation in routine clinical practice, patients with left bundle-branch block (LBBB) and a QRS duration (electrocardiogram pattern) of 150 millisecond (ms) or greater, compared with LBBB and QRS duration less than 150 ms or no LBBB regardless of QRS duration, had lower risks of mortality and heart failure readmission. These findings support the use of QRS morphology and duration to help identify patients who will have the greatest benefit from CRT-D implantation. The report, titled "QRS Duration, Bundle-Branch Block Morphology, and Outcomes Among Older Patients With Heart Failure Receiving Cardiac Resynchronization Therapy," appeared in the August 14 issue of The Journal of the American Medical Association (JAMA). Select to access the abstract on PubMed®.

3. AHRQ's "Questions Are the Answer" Offers Tools to Promote Patient Involvement

"Questions Are the Answer," AHRQ's ongoing public education initiative on patient involvement, offers several consumer tools to improve communication between patients and clinicians to help make health care safer. AHRQ's Web site features these valuable tools:

  • A 7-minute DVD of patients and clinicians discussing the importance of asking questions and sharing information, which is ideal for a lobby or waiting room area.
  • A brochure, titled "Be More Involved in Your Health Care: Tips for Patients," that offers helpful suggestions to follow before, during, and after a medical visit.
  • Notepads to help patients prioritize the top three questions they wish to ask during their medical appointment.

"Questions Are the Answer" is designed to promote safer care and better health outcomes. To request a free supply of these materials, email AHRQpubs@ahrq.hhs.gov or call 1-800-358-9295.

4. Register Now for August 29 AHRQ Webinar on Using EHR Data to Improve Care

AHRQ is hosting a webinar on August 29 from 1:30 to 3:00 p.m. ET to discuss advances in using electronic health record (EHR) data to improve research and clinical care. Panelists will present lessons from mature research networks on using EHR data to improve care quality; challenges of using EHR-derived measurements for quality reporting; and planned use of EHRs to collect and report quality measures for pediatric patients. Presenters include Lynne Nemeth, Ph.D., Associate Professor, Medical University of South Carolina; Amanda Parsons, M.D., Deputy Commissioner of Health Care Access and Improvement, New York City Department of Health and Mental Hygiene; and Elizabeth Alpern, M.D., Director, Section of Research, Children's Hospital of Philadelphia. The moderator is Jon White, M.D., Director, AHRQ Health Information Technology Portfolio. Select to register for the webinar.  

5. Save the Date: AHRQ to Host Healthcare Cost and Utilization Project Webinars on Sept. 18 and 25

AHRQ is hosting a two-part webinar on September 18 and 25 to provide health services and policy researchers with an overview of the Healthcare Cost and Utilization Project (HCUP) databases and related resources to enhance research studies. Both webinars run from 2:00 to 3:00 p.m. ET. Each requires separate registration, which begins September 11. Select to access additional information about HCUP.

6. AHRQ Announces Health IT Career Development and Dissertation Research Grants

AHRQ has published a Special Emphasis Notice (SEN) to support health information technology (IT) career development (K08) and research dissertation (R36) grants. This SEN is focused on five research areas including health IT design, implementation, use, impact on outcomes, and measurement. These areas of interest are critical to supporting health care quality and are considered part of a continuous quality improvement process. Select to access additional information on these grants.

7. AHRQ's Patient Safety Network Offers Primer on Efforts to Prevent "Never Events"

Health care organizations are under increasing pressure to eliminate "never events," which are medical errors such as wrong-site surgery that should never occur. Though they rarely occur, these 29 events may indicate fundamental safety problems within a health care organization. AHRQ's Patient Safety Network (PSNet) offers a primer that describes these events, which of them are most commonly reported, and current national efforts to encourage health care organizations to report, analyze, and disclose such errors in order to improve quality. Select to access the full patient safety primer, titled "Never Events."

8. AHRQ in the Professional Literature

Paddison CA, Elliott MN, Haviland AM, et al. Experiences of care among Medicare beneficiaries with ESRD: Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey results. Am J Kidney Dis. 2013 Mar; 61(3):440-9. Epub 2012 Nov 21. Select to access the abstract on PubMed®.

Cooke CR, Iwashyna TJ. Using existing data to address important clinical questions in critical care. Crit Care Med. 2013 Mar; 41(3):886-96. Select to access the abstract on PubMed®.

Mark BA, Harless DW, Spetz J, et al. California's minimum nurse staffing legislation: results from a natural experiment. Health Serv Res. 2013 Apr; 48(2 Pt 1):435-54. Epub 2012 Sep 21. Select to access the abstract on PubMed®.

Lorch SA, Srinivas SK, Ahlberg C, et al. The impact of obstetric unit closures on maternal and infant pregnancy outcomes. Health Serv Res. 2013 Apr; 48(2 Pt 1):455-75. Epub 2012 Aug 10. Select to access the abstract on PubMed®.

Pylypchuk Y, Sarpong EM. Comparison of health care utilization: United States versus Canada. Health Serv Res. 2013 Apr; 48(2 Pt 1):560-81. Epub 2012 Sep 25. Select to access the abstract on PubMed®.

Lindrooth RC, Konetzka RT, Navathe AS, et al. The impact of profitability of hospital admissions on mortality. Health Serv Res. 2013 Apr; 48(2 Pt 2):792-809. Epub 2013 Jan 24. Select to access the abstract on PubMed®.

Cartmill RS, Walker JM, Blosky MA, et al. Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. Int J Med Inform. 2012 Nov; 81(11):782-91. Epub 2012 Sep 2. Select to access the abstract on PubMed®.

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Page last reviewed August 2013
Internet Citation: AHRQ Study Suggests New Metric for Assessing Care of Heart Failure Patients: Electronic Newsletter, Issue 393. August 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/393.html