Opioid Prescribing Nearly 40 Times Higher Among U.S. vs. English Dentists

AHRQ Stats: Hospital Participation in a Medicare Bundled Payment Model

About 28 percent of hospitals that are part of health systems participated in a Medicare bundled payment model in 2016, whereas only 8 percent of nonsystem hospitals participated in Medicare bundled payment models. (Source: AHRQ, Compendium of U.S. Health Systems—Health System Participation in Medicare Bundled Payment Models, 2016 [PDF, 319 KB].) 

Today's Headlines

• Opioid Prescribing Nearly 40 Times Higher Among U.S. vs. English Dentists.
• Accountable Care Organizations More Likely To Use Home Visits To Help Manage Complex Patients’ Care.
• AHRQ Views Blog: Joining AcademyHealth in Advancing Better Healthcare for All Americans.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Opioid Prescribing Nearly 40 Times Higher Among U.S. vs. English Dentists

Although patients in the United States and England go to the dentist at similar rates, American dentists wrote 11.4 million prescriptions for opioids in 2016, compared with about 28,000 prescriptions written by their British counterparts, according to a new AHRQ study. Dentists are one of the most frequent prescribers of opioids, even though data suggest that non-opioid pain relievers are similarly effective for oral pain. The study, published in JAMA Network Open, compared prescriptions by dentists in both countries for opioids from outpatient pharmacies and healthcare settings. They found that the proportion of prescriptions written by U.S. dentists was 37 times greater than those written by English dentists. U.S. dentists also prescribed long-acting opioids (e.g., oxycodone, meperidine), while English dentists did not. To reduce opioid prescribing, the authors suggested that U.S. dentists adapt measures like those used in England, including national guidelines for treating dental pain that emphasize a more conservative use of opioids. Access the article. 

Accountable Care Organizations More Likely To Use Home Visits To Help Manage Complex Patients’ Care

Accountable care organizations (ACOs) are more likely to use home visits to manage patients who have complex medical needs than non-ACO physician practices, a new AHRQ-funded study published in Health Affairs found. Home visits have been shown to improve care transitions following hospital discharge and enhance overall care management, and Medicare has created new reimbursement models to support home visits for some patients. In the study, ACOs reported three main home visit activities: assessing patients’ needs, reconciling medications use and identifying patient barriers to effective care. Among Medicare ACOs, researchers found no differences in quality scores or likelihood of achieving shared savings between ACOs that used home visits and those that did not. Researchers noted that, despite their perceived value, implementing home visits for some types of patients can be challenging because of barriers related to reimbursement, staffing and resources. Access the article.

AHRQ Views Blog: Joining AcademyHealth in Advancing Better Healthcare for All Americans

AHRQ's participation in this week’s AcademyHealth's Annual Research Meeting in Washington, D.C., is the subject of a blog post by agency Director Gopal Khanna, M.B.A. On Monday, Director Khanna joined AHRQ Chief Physician David Meyers, Kaiser Permanente’s Beth McGlynn, America’s Essential Hospitals’ Bruce Siegel and University Hospitals Health System’s Peter Pronovost in a session titled “Increasing Impact: A Vision for AHRQ’s Future.” Additional AHRQ-supported presentations and posters at the meeting highlighted new findings, data and implementation strategies, all at a time when mergers and acquisitions, emerging technologies, shifting demographics and an explosion in the availability of data present unprecedented challenges and opportunities in healthcare delivery. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog."

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:

• How do nurses use early warning scoring systems to detect and act on patient deterioration to ensure patient safety? A scoping review.
• Transition planning for the senior surgeon: guidance and recommendations from the Society of Surgical Chairs.
• Transcription errors of blood glucose values and insulin errors in an intensive care unit: secondary data analysis toward electronic medical record–glucometer interoperability.

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 in the Professional Literature

Rural health care costs: are they higher and why might they differ from urban health care costs? Williams D, Jr., Holmes M. N C Med J 2018 Jan-Feb;79(1):51-5. Access the abstract on PubMed®.

Characteristics of interim publications of randomized clinical trials and comparison with final publications. Woloshin S, Schwartz LM, Bagley PJ, et al. JAMA 2018 Jan 23;319(4):404-6. Access the abstract on PubMed®.

Evaluation of 'definite' anaphylaxis drug allergy alert overrides in inpatient and outpatient settings. Wong A, Seger DL, Slight SP, et al. Drug Saf 2018 Mar;41(3):297-302. Access the abstract on PubMed®.

Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals. Yang L, Liu C, Huang C, et al. BMC Health Serv Res 2018 Jan 29;18(1):50. Access the abstract on PubMed®.

Two alternatives versus the standard Grading of Recommendations Assessment, Development and Evaluation (GRADE) summary of findings (SoF) tables to improve understanding in the presentation of systematic review results: a three-arm, randomised, controlled, non-inferiority trial. Yepes-Nuñez JJ, Morgan RL, Mbuagbaw L, et al. BMJ Open 2018 Jan 23;8(1):e015623. Access the abstract on PubMed®.

Dementia and motor vehicle crash hospitalizations: role of physician reporting laws. Agimi Y, Albert SM, Youk AO, et al. Neurology 2018 Feb 27;90(9):e808-e13. Epub 2018 Jan 31. Access the abstract on PubMed®.

Approach to assessing and using clinical practice guidelines. Armstrong MJ, Gronseth GS. Neurol Clin Pract 2018 Feb;8(1):58-61. Access the abstract on PubMed®.

Age trends in 30 day hospital readmissions: US national retrospective analysis. Berry JG, Gay JC, Joynt Maddox K, et al. BMJ 2018 Feb 27;360:k497. Access the abstract on PubMed®.