While Hospital Admissions Decline, Observation Stays and Emergency Department Visits on the Rise

Issue 587
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
October 17, 2017

AHRQ Stats: Trends in Emergency Department Visits

Emergency department (ED) visits increased 15 percent from 2006 to 2014. During that time, ED visits for injuries decreased by 13 percent while ED visits for mental health/substance abuse increased by 44 percent. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #227: Trends in Emergency Department Visits, 2006-2014.)

Today's Headlines:

While Hospital Admissions Decline, Observation Stays and Emergency Department Visits on the Rise

Trends showing fewer hospital admissions and more treat-and-release observation stays or emergency department (ED) visits have occurred among patients across all insurance categories, according to a recent AHRQ-funded study. “The Shifting Landscape in Utilization of Inpatient, Observation, and Emergency Department Services Across Payers,” published in the Journal of Hospital Medicine, showed hospital admissions decreased while observation and ED visits increased from 2009 to 2013 among patients who were uninsured or covered by Medicare, Medicaid or private insurance. Among Medicare patients, for example, admissions fell by 17 percent while observation stays increased by 33 percent. The study analyzed data from AHRQ's Healthcare Cost and Utilization Project for 10 common conditions in four states. Access the abstract.

AHRQ Views Blog Post: AHRQ 2.0: Strategies for Creating Value in the Digital Age

In a new AHRQ Views blog post, AHRQ Director Gopal Khanna, M.B.A., provides additional information about his vision for AHRQ. This four-part vision, which centers on increasing use of data, includes developing a platform to create data-informed insights, catalyzing the evolution of learning health systems, engaging health care operation leaders in health services research, and empowering 360° person-centered care. Access the blog post to learn more about the four parts of the vision and how Director Khanna hopes to achieve them.

New AHRQ Grantee Profile Highlights Work of Thomas Payne, M.D., on Customizing Health Information Technology To Reduce Physician Burden

AHRQ’s latest grantee profile explores how agency funding helped Thomas Payne, M.D., and his team at the University of Washington Medical Center in Seattle develop and implement a voice-generated enhanced electronic note system, or VGEENS, to translate clinical notes into usable, actionable information in a clinical electronic health record. The system has the potential to reduce clinician burden, speed access to information for the care team and improve the care provided to patients. The system was designed to match physicians’ workflow during inpatient rounds to improve accuracy and timely availability of inpatient progress notes. Check out his profile and profiles of other AHRQ grantees who have made major advances in health services research.

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).

Study Estimates Costs of Becoming a Patient-Centered Medical Home

AHRQ-funded researchers exploring the costs of becoming a patient-centered medical home (PCMH) estimated that a Texas medical group with 57 primary care practices paid about $2.5 million to secure the designation. PCMHs have shown promise for improving care and reducing costs. The National Committee for Quality Assurance (NCQA) designates PCMHs as those that meet criteria in areas such as team-based care, population management, care coordination and performance measurement. Researchers used surveys and interviews to estimate HealthTexas' NCQA designation costs, which averaged approximately $43,000 per practice. While acknowledging that cost estimates could not be generalized to other medical groups, researchers concluded the benefits of becoming a PCMH should be weighed against mixed evidence regarding impacts on quality and costs of care. Access the abstract of the article, published in the Journal of the American Board of Family Medicine. For more information, access Estimating the Costs of Primary Care Transformation: A Practical Guide and Synthesis Report, an AHRQ report based on the experiences of 15 grantees that sought to understand how much it costs for primary care practices to become PCMHs.

TeamSTEPPS for Office-Based Care Online Course: No-Cost CE/CME Available

Register now for AHRQ’s free TeamSTEPPS® for Office-Based Care Online course, which focuses on enhancing communication and teamwork skills among office-based professionals to improve patient safety and quality. Participants may begin pre-course work now and will earn no-cost continuing education for each activity completed. Master Trainer certificates will be awarded for completing all course requirements. TeamSTEPPS for Office-Based Care offers techniques, tools and strategies to assist health care professionals in developing and optimizing team knowledge and performance in a medical office setting. It is a full version of TeamSTEPPS that is intended for individuals who play a key role in leading and assisting office-based practices with quality improvement and practice transformation efforts. To learn more, watch the onboarding video or email questions to obc-questions@tslms.org.

Good Work Conditions Promote Clinician Job Satisfaction, Reduce Burnout

Well-functioning workplaces that promote trust, communication and quality over productivity minimize physicians’ burnout and their desire to leave medical practice, according to a recent AHRQ-funded study in Health Affairs. Concerns about job satisfaction among physicians have increased in recent years following changes to reimbursement rules, pressures to adopt electronic records and demands for high productivity. To understand more, researchers examined data from 168 clinicians in 34 clinics. At baseline, 74 percent of respondents indicated that they were satisfied with their jobs (scoring 3.5 or higher on 5-point satisfaction scale). One year later, researchers found that clinicians whose satisfaction had increased were more likely to report better scores on measures of burnout and less likely to want to leave practice. The findings confirmed that clinician satisfaction is related to work conditions that can be modified and is an important metric for clinical practices to measure, researchers concluded. Access the abstract.

AHRQ in the Professional Literature

Postoperative bleeding and associated utilization following tonsillectomy in children. Francis DO, Fonnesbeck C, Sathe N, et al. Otolaryngol Head Neck Surg 2017 Mar;156(3):442-55. Epub 2017 Jan 17. Access the abstract on PubMed®.

Leveraging user's performance in reporting patient safety events by utilizing text prediction in narrative data entry. Gong Y, Hua L, Wang S. Comput Methods Programs Biomed 2016 Jul;131:181-9. Epub 2016 Apr 8. Access the abstract on PubMed®.

Disparities in TKA outcomes: census tract data show interactions between race and poverty. Goodman SM, Mandl LA, Parks ML, et al. Clin Orthop Relat Res 2016 Sep;474(9):1986-95. Epub 2016 Jun 8. Access the abstract on PubMed®.

Participatory design of ehealth solutions for women from vulnerable populations with perinatal depression. Gordon M, Henderson R, Holmes JH, et al. J Am Med Inform Assoc 2016 Jan;23(1):105-9. Epub 2015 Sep 5. Access the abstract on PubMed®.

Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states. Green TC, Case P, Fiske H, et al. J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2s):S19-S27.e4. Epub 2017 Feb 14. Access the abstract on PubMed®.

Detecting naloxone prejudices in the pharmacy setting. Green TC, Potter N, Bratberg J. J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S10-S11. Epub 2017 Jan 31. Access the abstract on PubMed®.

Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York. Greenberg JK, Olsen MA, Yarbrough CK, et al. J Neurosurg Pediatr 2016 May;17(5):525-32. Epub 2016 Jan 22. Access the abstract on PubMed®.

Periodic screening pelvic examination: evidence report and systematic review for the US Preventive Services Task Force. Guirguis-Blake JM, Henderson JT, Perdue LA. JAMA 2017 Mar 7;317(9):954-66. Access the abstract on PubMed®.

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Page last reviewed October 2017
Page originally created October 2017
Internet Citation: While Hospital Admissions Decline, Observation Stays and Emergency Department Visits on the Rise. Content last reviewed October 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/587.html