New AHRQ Report Shows 65 Percent Increase in Breast Reconstruction Surgeries After Mastectomies

Issue 586
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
October 11, 2017

AHRQ Stats: Insurance Payments for Child Orthopedic Visits

The average payment for a child’s visit to an orthopedist when covered by private insurance was $423 in 2014-2015, compared with $162 when covered by Medicaid. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #504: Differences in Payments for Child Visits to Office-Based Physicians: Private versus Medicaid Insurance, 2010 to 2015.)

Today's Headlines:

New AHRQ Report Shows 65 Percent Increase in Breast Reconstruction Surgeries After Mastectomies

The portion of women who elected to have breast reconstruction surgeries after mastectomies increased 65 percent between 2009 and 2014, with the sharpest rise occurring among women 65 and older, according to a new analysis by AHRQ. During the same timeframe, reconstructive surgeries increased more than 150 percent in outpatient settings while reconstructions in inpatient settings stayed stable. The new statistical brief, released during Breast Cancer Awareness Month, was developed by AHRQ researchers who mined data from the Agency’s Healthcare Cost and Utilization Project, the nation’s most comprehensive source of hospital data, including information on inpatient care, ambulatory care and emergency department visits. The new analysis found that, while about 24 in 100 women chose reconstruction surgery following a mastectomy in 2009, that rate rose to about 40 women out of every 100 in 2014. The analysis also found that in 2014, women who lived in rural areas had fewer reconstructions (29 per 100 mastectomies) compared with urban-dwelling women (41 reconstructions per 100 mastectomies), and that black women were more likely to receive breast reconstruction surgery in an inpatient setting compared with white and Hispanic women. Access AHRQ’s press release to learn more.

Hospital Data Show Sharp Increase in Heroin Overdoses While Prescription Opioid Overdoses Have Declined

Overdoses from heroin and other illicit opioids have accelerated sharply since 2008 while overdoses by prescription opioids have declined since 2010, according to a new AHRQ-funded study in Health Affairs. Researchers used the agency’s Healthcare Cost and Utilization Project data to analyze national trends in hospital inpatient and emergency department (ED) discharges for opioid abuse, dependence and poisoning. Between 2008 and 2014, opioid-related ED discharge rates for heroin overdoses increased by about 31 percent a year, researchers found. Meanwhile, inpatient and ED discharge rates for overdoses by prescription opioids each declined by about 5 percent a year between 2010 and 2014. The authors concluded that further research on prescribing patterns and the indirect costs of heroin’s increased burden on the legal system could guide policies to curb and manage the epidemic. Access the abstract. The research follows a recent AHRQ statistical brief that examined opioid-related hospital trends for prescription opioids and heroin combined. Among other findings, that analysis of patient characteristics showed that hospitalizations involving opioids increased 75 percent for women between 2005 and 2014, significantly outpacing the 55 percent increase among men.

New AHRQ Grantee Profile Highlights Work of Nasia Safdar, M.D., in Combating Healthcare-Associated Infections

Our latest grantee profile examines how AHRQ funding has helped Nasia Safdar, M.D., medical director of infection control at the University of Wisconsin Hospitals and Clinics, identify better ways to prevent healthcare-associated infections and make care safer. Dr. Safdar is currently studying how to prevent and treat Clostridium difficile, a type of infection that’s commonly associated with prolonged antibiotic use. Check out her profile and those of other AHRQ grantees who have made major strides in health services research.

AHRQ Study Finds Link Between Hospital Characteristics and Sepsis Death Rates

Higher inpatient death rates from sepsis seen among blacks and Hispanics may be associated with hospital characteristics, according to new AHRQ research. A study published in Critical Care Medicine estimated sepsis mortality rates between 2004 and 2013 using data from AHRQ’s Healthcare Cost and Utilization Project. It found that after adjusting for hospital characteristics, sepsis mortality rates (which are falling overall) were similar in 2013 for white, black and Hispanic patients. However, sepsis mortality rates remained elevated for Asian/Pacific Islanders and patients classified as belonging to “other” racial/ethnic groups. Hospital characteristics that affected mortality included status as teaching, critical access or safety-net hospitals; urban or rural location; ownership status; and size. Access the abstract.

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).

Upcoming Webinars To Encourage Hospital Participation in Antibiotic Stewardship Project

Registration is open for webinars on Oct. 17 and Nov. 9, both from 3 to 4 p.m. ET, to highlight how hospitals can join a national project to reduce harms related to inappropriate use of antibiotics while preserving antibiotics’ effectiveness for future generations. The 12-month project, offered at no charge to hospitals, will begin in December. Participating hospitals will receive antibiotic-use guidelines for several infectious disease syndromes, expert coaching, online education, improvement tools, patient education materials and other resources to help run an effective antibiotic stewardship program. Using AHRQ’s Comprehensive Unit-based Safety Program, hospitals will also address the cultural, organizational and behavioral factors that underlie antibiotic ordering habits. Access more information on the project.

Featured Case Study: AHRQ Program Helps Reduce Patient Safety Events, Malpractice Claims at MedStar Health

MedStar Health, located in the Baltimore, Md./Washington, D.C., area, reduced serious patient safety events by about 65 percent and reduced the cost of care associated with serious safety events (including medical liability payments) by more than $70 million since 2012. The successes followed implementation of a comprehensive patient safety program, including strategies from AHRQ's Communication and Optimal Resolution (CANDOR) toolkit. Access the case study.

AHRQ in the Professional Literature

Primary care clinic re-design for prescription opioid management. Parchman ML, Von Korff M, Baldwin LM, et al. J Am Board Fam Med 2017 1/2;30(1):44-51. Access the abstract on PubMed®.

Trends over time in enrollment in non-group health insurance plans by tobacco use in the United States. Pesko MF, Maclean JC, Kaplan CM, et al. Prev Med Rep 2017 May 17;7:46-9. eCollection 2017 Sep. Access the abstract on PubMed®.

Graduating pediatric residents entering the hospital medicine workforce, 2006-2015. Leyenaar JK, Frintner MP. Acad Pediatr 2017 May 11. [Epub ahead of print.] Access the abstract on PubMed®.

Querying stakeholders to inform comparative effectiveness research. Hong YD, Goto D, Mullins CD. J Comp Eff Res 2017 May 9. [Epub ahead of print.] Access the abstract on PubMed®.

The Project Protect Infection Prevention Fellowship: a model for advancing infection prevention competency, quality improvement, and patient safety. Reisinger JD, Wojcik A, Jenkins I, et al. Am J Infect Control 2017 Aug 1;45(8):876-82. Epub 2017 May 2. Access the abstract on PubMed®.

Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine. Benda NC, Fairbanks RJ, Fairbanks RJ. Ann Emerg Med 2017 May;69(5):669-70. Access the abstract on PubMed®.

Incidence, predictors, and outcomes of hospital-acquired anemia. Makam AN, Nguyen OK, Clark C, et al. J Hosp Med 2017 May;12(5):317-22. Access the abstract on PubMed®.

Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease. Snyder GM, McCoy C, D'Agata EM. Infect Control Hosp Epidemiol 2017 Mar;38(3):360-3. Epub 2016 Dec 5. Access the abstract on PubMed®.

Contact Information

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Page last reviewed October 2017
Page originally created October 2017
Internet Citation: New AHRQ Report Shows 65 Percent Increase in Breast Reconstruction Surgeries After Mastectomies. Content last reviewed October 2017. Agency for Healthcare Research and Quality, Rockville, MD.
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