AHRQ Showcases Research on Strategies To Address Physician Burnout
AHRQ Stats: Insurance Coverage For Hospital Stays
From 2005 to 2014, the number of Medicaid-insured hospital stays increased nearly 16 percent, while privately insured and uninsured hospital stays both decreased nearly 13 percent. Medicare-insured stays remained essentially unchanged. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #225: Trends in Hospital Inpatient Stays in the United States, 2005-2014.)
- AHRQ Showcases Research on Strategies To Address Physician Burnout.
- Dialysis Patient Death Rates Linked to Hospital Readmissions.
- Highlights From AHRQ’s Patient Safety Network.
- New Publication for Clinicians Summarizes Evidence on Managing Renal Masses.
- AHRQ Review: Consistent Definition Lacking for “High Performing” Health System.
- New AHRQ Views Blog Post.
- AHRQ in the Professional Literature.
A new AHRQ Views blog looks at factors that can contribute to physician burnout, including a lack of control over work conditions, time pressures, chaotic workplaces and difficulties associated with electronic health records. Co-authored by Gopal Khanna, M.B.A., the agency’s director, and Arlene Bierman, M.D., director of AHRQ’s Center for Evidence and Practice Improvement, the blog also offers potential strategies to minimize burnout, such as expanding the ways nurses and medical assistants might interact with patients. In addition to the blog, AHRQ has profiled grantee Mark Linzer, M.D., of Hennepin County Medical Center in Minneapolis, who has studied working conditions in health care, especially as they contribute to burnout, for the past 15 years and has created a tool to measure burnout. For more information about AHRQ’s work on physician burnout, access our online fact sheet.
Dialysis patients who were readmitted to a hospital within 30 days of discharge were up to twice as likely to die compared with those not readmitted, an AHRQ study found. Researchers examined nearly 300,000 dialysis patient admissions from 2010 to 2013. Of those, 23 percent resulted in a readmission within 30 days of discharge. More than one-third of readmissions occurred within a week of discharge, and about 6 percent occurred on the same day. Recent policies propose penalizing dialysis facilities for 30-day readmissions, but this study suggested that facilities may often have limited time and opportunities to influence readmissions. Regardless of timing, patients with readmissions had a higher risk of death within one year. Access the abstract of the article, which was published in Kidney International.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Performance of a trigger tool for identifying adverse events in oncology.
- Pictograms, units and dosing tools, and parent medication errors: a randomized study.
- Randomized trial of reducing ambulatory malpractice and safety risk: results of the Massachusetts PROMISES Project.
A new evidence-based publication from AHRQ can help clinicians make informed decisions about managing renal masses and localized renal cell carcinoma—a kidney cancer that affects approximately 65,000 new patients each year. Management of Renal Masses and Localized Renal Cell Carcinoma: Current State of the Evidence summarizes findings of a systematic review that evaluated the benefits and adverse effects of screening and treating patients with a renal mass that potentially could be localized renal cell carcinoma. Evidence indicates there is no clear method for predicting kidney cancer during diagnosis of renal masses. Tumor size and male gender, however, are highly associated with malignancy. In addition, evidence does not support one management strategy over another; treatment decision-making may be affected by patient factors such as comorbidities, life expectancy, tumor characteristics (e.g., size and location) and patient values and preferences.
Health services research currently lacks a consistent definition of a "high performing" health care delivery system despite an increased emphasis by health care purchasers, payers and policymakers on measuring and rewarding such systems, according to an AHRQ-funded systematic literature review. Without a consistent definition, the review authors indicated, it is less meaningful to compare the performance of different systems and severely limits the ability to develop a general policy, or reward system, for achieving high performance. Although all definitions found in the literature review used one or more attributes to define high performance, only five studies used five or more attributes. Of the attributes used most often—quality, cost, access, equity, patient experience and safety—quality and cost were most commonly paired. This research was funded by AHRQ’s Comparative Health System Performance Initiative, which studies how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Access the abstract, published July 10 in the Joint Commission Journal on Quality and Patient Safety.
Preoperative pain and function: profiles of patients selected for total knee arthroplasty. Nguyen UD, Ayers DC, Li W, et al. J Arthroplasty 2016 Nov;31(11):2402-7.e2. Epub 2016 Apr 27. Access the abstract on PubMed®.
The burden of clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases. Olsen MA, Young-Xu Y, Stwalley D, et al. BMC Infect Dis 2016 Apr 22;16:177. Access the abstract on PubMed®.
Personal health budgets for patients with complex needs. O'Shea L, Bindman AB. N Engl J Med 2016 Nov 10;375(19):1815-17. Access the abstract on PubMed®.
Severe hypoglycemia requiring medical intervention in a large cohort of adults with diabetes receiving care in U.S. integrated health care delivery systems: 2005-2011. Pathak RD, Schroeder EB, Seaquist ER, et al. Diabetes Care 2016 Mar;39(3):363-70. Epub 2015 Dec 17. Access the abstract on PubMed®.
Characterizing a naturalistic decision making phenomenon: loss of system resilience associated with implementation of new technology. Patterson ES, Militello LG, Su G, et al. J Cogn Eng Decis Mak 2016 Sep;10(3):229-43. Epub 2016 Jun 15. Access the abstract on PubMed®.
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations. Ratanawongsa N, Chan LL, Fouts MM, et al. J Diabetes Res 2017;2017:8983237. Epub 2017 Jan 18. Access the abstract on PubMed®.
Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States veterans from 1997 to 2011. Rentsch C, Tate JP, Akgün KM, et al. AIDS Behav 2016 Mar;20(3):555-64. Access the abstract on PubMed®.
Progress at the intersection of patient safety and medical liability: insights from the AHRQ Patient Safety and Medical Liability Demonstration Program. Ridgely MS, Greenberg MD, Pillen MB, et al. Health Serv Res 2016 Dec;51 Suppl 3:2414-30. Access the abstract on PubMed®.
For comments or questions about AHRQ News Now, contact Bruce Seeman at Bruce.Seeman@ahrq.hhs.gov or (301) 427-1998.
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Page originally created July 2017