AHRQ Annual Report Shows More Americans Have Health Insurance and Receive Safer Care, but Gains Remain Uneven Among Minorities

Issue 578
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
August 15, 2017

AHRQ Stats: Coverage for Patients With Chronic Conditions

About 15 percent of Americans under 65 with no chronic conditions lacked health insurance throughout 2015, down from about 23 percent in 2013. The trend was similar among nonelderly adults with at least one chronic condition, whose uninsurance rate dropped to about 9 percent in 2015 from 16 percent in 2013. (Source: AHRQ, Medical Expenditure Panel Survey Research Findings #36: Uninsurance and Insurance Transitions, 2012-2013 through 2014-2015: Estimates for U.S., Non-Elderly Adults by Health Status, Presence of Chronic Conditions, and State Medicaid Expansion Status.)

Today's Headlines:

AHRQ Annual Report Shows More Americans Have Health Insurance and Receive Safer Care, but Gains Remain Uneven Among Minorities

AHRQ's 2016 National Healthcare Quality and Disparities Report shows that the quality of health care continues to improve gradually each year but gains remain uneven among minorities. Some of the biggest improvements are in measures of "person-centered care," such as communication between doctors and their patients, and the safety of medical care, such as fewer complications among hospital patients who were taking anticoagulants other than warfarin.The report also indicates that fewer people were uninsured, as 11 percent of people under age 65 were uninsured in 2016 compared with 18 percent in 2010. However, most disparities in health care quality continued to persist, with no significant improvements for any racial or ethnic groups, especially people in poor, low-income and uninsured households as well as blacks and Hispanics. As a companion to the report, AHRQ's Chartbook on Patient Safety provides new data on dozens of safety measures, such the rate of central line-associated bloodstream infections decreasing by more than 40 percent between 2009 and 2014. Access an AHRQ Views blog on AHRQ's new report and chartbook.

Patient Mortality Declines Shown at Hospitals Using Surgical Checklist Program

Patient deaths following surgery declined significantly from 2011 to 2013 at South Carolina hospitals where staff completed a voluntary checklist of patient safety safeguards, according to an AHRQ-funded study. The mortality rate following inpatient surgery declined 22 percent among patients at 14 hospitals that completed the checklist-based safety program. The checklist included safeguards such as identifying patients by name and date of birth before administering anesthesia, confirming surgical procedures to be performed and having an advance team briefing about the operative plan and potential difficulties. As a team-based tool, the checklist was designed to promote stronger communication among surgical staff to increase patient safety. The study's authors concluded that broad, ongoing participation of both frontline clinicians and hospital leadership is necessary to produce behavioral change among surgical teams. The study found no change in mortality rates among 44 other hospitals statewide that did not complete the program. Access the abstract of the study, which was published in the Annals of Surgery.

Highlights From AHRQ's Patient Safety Network

AHRQ's Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet's current issue or access recent cases and commentaries in AHRQ's WebM&M (Morbidity and Mortality Rounds on the Web).

AHRQ Seeks Nominations to Its National Advisory Council

Nominations are being accepted to AHRQ's National Advisory Council, a 21-member volunteer panel that meets three times a year to advise the agency's director and the HHS secretary on matters related to AHRQ's mission. Nominees may nclude experts in health care quality and improvement, clinical practice, health insurance, health care administration, economics, informatics, health care law, public policy or the private sector. The agency also welcomes nominees from small health care systems as well as state and local human services organizations. The nomination deadline is Aug. 27.

Community Health Center Patients More Likely To Have Insurance After Medicaid Expansion and Subsidies

In states that expanded Medicaid under provisions of the Affordable Care Act, primary care visits to community health centers where a patient had no insurance dropped by 57 percent between 2012 and 2015, a new AHRQ study showed. That compares to a 20 percent decline in the uninsured rate in states that did not expand Medicaid.  In addition, the rate of visits paid for by private insurance were 2.7 times higher in non-expansion states, but did not increase in states that expanded Medicaid. Researchers examined electronic health record data in 13 states from more than 875,000 patients between the ages of 19 and 64 who had more than one ambulatory visit to a community health center between 2012 and 2015. Access the abstract of the article, which was published in the Journal of Primary Care & Community Health.

AHRQ in the Professional Literature

A new era in quality measurement: the development and application of quality measures. Adirim T, Meade K, Mistry K, et al. Pediatrics 2017 Jan;139(1). Access the abstract on PubMed®.

Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO. Banerjee T, Meyer TW, Shafi T, et al. Medicine 2017 Feb;96(6):e5799. Access the abstract on PubMed®.

Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders. Bauer NS, Carroll AE, Saha C, et al. J Am Med Inform Assoc 2016 Apr;23(e1):e125-30. Epub 2015 Nov 13. Access the abstract on PubMed®.

Provider variation in responses to warnings: do the same providers run stop signs repeatedly? Beeler PE, Orav EJ, Seger DL, et al. J Am Med Inform Assoc 2016 Apr;23(e1):e93-8. Epub 2015 Oct 24. Access the abstract on PubMed®.

Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living. Berridge C. Ageing Soc 2017 Mar;37(3):537-60. Epub 2015 Nov 13. Access the abstract on PubMed®.

The high and rising costs of obesity to the US health care system. Biener A, Cawley J, Meyerhoefer C. J Gen Intern Med 2017 Apr;32(Suppl 1):6-8. Access the abstract on PubMed®.

The long-term impacts of Medicaid exposure in early childhood: evidence from the program's origin. Boudreaux MH, Golberstein E, McAlpine DD. J Health Econ 2016 Jan;45:161-75. Epub 2015 Nov 19. Access the abstract on PubMed®.

Inference and sample size calculation for clinical trials with incomplete observations of paired binary outcomes. Zhang S, Cao J, Ahn C. Stat Med 2017 Feb 20;36(4):581-91. Epub 2016 Nov 10. Access the abstract on PubMed®.

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Page last reviewed August 2017
Page originally created August 2017
Internet Citation: AHRQ Annual Report Shows More Americans Have Health Insurance and Receive Safer Care, but Gains Remain Uneven Among Minorities. Content last reviewed August 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/578.html