AHRQ Study Proposes Using New Life Expectancy Approach to Measure Racial, Ethnic Disparities
In 2011, the most common causes of adverse drug events originating during a hospital stay were steroids, antibiotics, opiates/narcotics, and anticoagulants. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #164: Characteristics of Adverse Drug Events Originating During the Hospital Stay, 2011.)
- AHRQ Study Proposes Using New Life Expectancy Approach to Measure Racial, Ethnic Disparities.
- Role of Physician Assistants, Nurse Practitioners on Primary Care Teams Examined in AHRQ Study.
- New Atlas Fills Need for Measuring Integrated Behavioral Health Care.
- AHRQ's Health Care Innovations Exchange Focuses on Better Access Through Virtual Visits.
- Editor's Note: Web Link for BMJ Supplement on Diagnostic Errors.
- AHRQ in the professional literature.
As a new way to measure health care disparities, a recent AHRQ study published in the October issue of Health Affairs analyzes health insurance status and medical need over a typical lifetime by ethnic group. This "life expectancy" approach can estimate the number of years that racial/ethnic groups are subject to "health insurance double jeopardy," which the authors describe as the state of being uninsured while also in lesser health and therefore at higher risk of needing medical care. The researchers, AHRQ's James Kirby and Toshiko Kaneda from the Population Reference Bureau, found that the expected years of life spent in "double jeopardy" were 11 years for Hispanics, 6 years for blacks, and 4 years for whites. The authors suggest this approach as a new way to monitor progress in eliminating disparities in insurance coverage, as called for by the Affordable Care Act. The study is titled, "‘Double Jeopardy' Measure Suggests Blacks and Hispanics Face More Severe Disparities Than Previously Indicated." Select to access the journal abstract on PubMed®.
Decisions about which health care services should be provided by physician assistants (PAs) and nurse practitioners (NPs) on the primary care team should be based on factors such as patient characteristics and identified goals, according to a new AHRQ study published online in the November issue of Health Affairs. The study, "Physician Assistants and Nurse Practitioners Perform Effective Roles on Teams Caring for Medicare Patients With Diabetes," compared outcomes in diabetes care for more than 2,500 Medicare patients in a large multi-specialty physician practice. Patients were sorted into two groups: those whose primary care teams included PAs and NPs in various roles, and those who received care from physicians only. Outcomes were generally the same for both groups in 13 of 20 comparisons. For four comparisons the PA/NP outcomes were better, and for three comparisons the physician-only outcomes were better. Select to access the journal abstract on PubMed®.
As greater numbers of primary care organizations implement integrated behavioral health services, there is a growing need to measure the extent to which integrated behavioral health care is being provided. The 2013 Atlas of Integrated Behavioral Health Care Quality Measures helps primary care organizations and researchers identify and assess quality measures for integrating behavioral health care. It was developed by AHRQ's Academy for Integrating Behavioral Health and Primary Care and features nine core measures that describe specific characteristics, actions, and selected outcomes of integrated care. All measures were chosen based on criteria established by a panel of experts. New measures will be added as they become available.
The latest issue of the AHRQ Health Care Innovations Exchange features three innovations that used virtual visits to increase patient access to health care. The programs include one in which a solo practitioner provided year-round, 24-hour-a-day access to care for her patients through liberal use of "virtual" or Email visits and telephone calls. The second program used an online clinic to diagnose and treat minor health problems with a protocol-based treatment plan. The third allowed patients with skin conditions to submit their medical history and photographs through secure, Web-based applications for review by a dermatologist. The featured Quality Tools include a website that offers resources on using technology to assist care coordination and improve the independence of older adults, a guide for developing a remote diabetic retinopathy screening program, and a toolkit for developing telehealth activities. Select to access more innovation profiles and tools related to virtual visits and telehealth.
Our November 5 issue included an item about a supplement on diagnostic error in medicine in the October issue of the British Medical Journal's BMJ Quality & Safety. Select to access the correct link for the supplement.
Scholle SH, Asche SE, Morton S, et al. Support and strategies for change among small patient-centered medical home practices. Ann Fam Med 2013 May-Jun; 11 Suppl 1:S6-S13. Select to access the abstract on PubMed®.
Radwin LE, Cabral HJ, Woodworth TS. Effects of race and language on patient-centered cancer nursing care and patient outcomes. J Health Care Poor Underserved 2013 May; 24(2):619-632. Select to access the abstract on PubMed®.
Dohan D, McCuistion MH, Frosch DL, et al. Recognition as a patient-centered medical home: fundamental or incidental? Ann Fam Med 2013 May-Jun; 11 Suppl 1:S14-S18. Select to access the abstract on PubMed®.
Quigley DD, Martino SC, Brown JA, et al. Evaluating the content of the communication items in the CAHPS Clinician and Group Survey and supplemental items with what high-performing physicians say they do. Patient 2013 May 29. Select to access the abstract on PubMed®.
Day J, Scammon DL, Kim J, et al. Quality, satisfaction, and financial efficiency associated with elements of primary care practice transformation: preliminary findings. Ann Fam Med 2013 May-Jun; 11 Suppl 1:S50-S59.Select to access the abstract on PubMed®.
Calman NS, Hauser D, Weiss L, et al. Becoming a patient-centered medical home: a 9-year transition for a network of Federally Qualified Health Centers. Ann Fam Med 2013 May-Jun; 11 Suppl1 :S68-S73. Select to access the abstract on PubMed®.
Berdahl TA, Friedman BS, McCormick MC, Simpson L. Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009. Acad Pediatr 2013 May-Jun; 13(3):191-203. Select to access the abstract on PubMed®.
McMullen CK, Schneider J, Firemark A, et al. Cultivating engaged leadership through a learning collaborative: lessons from a primary care renewal in Oregon safety net clinics. Ann Fam Med 2013 May-Jun; 11 Suppl 1:S34-S40. Select to access the abstract on PubMed®.
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