Many Clinically Necessary Radiology Exams Remain Unscheduled After 30 Days

AHRQ Stats: Employee Share of Healthcare Premiums

Among private-sector establishments offering health insurance in 2018, enrolled employees paid 21.3 percent of the premium for single coverage, 27.1 percent for employee-plus-one coverage, and 27.8 percent for family coverage. (Source: AHRQ, Medical Expenditure Panel Survey—Insurance Component 2018 Chartbook.) 

Today's Headlines:

• Many Clinically Necessary Radiology Exams Remain Unscheduled After 30 Days.
• Use of Osteoarthritis Decision Aids Led to More Hip, Knee Replacement Surgeries.
• Nominations Due Feb. 28 for Healthcare Cost and Utilization Project Outstanding Article of the Year .
• Highlights From AHRQ’s Patient Safety Network.
• Study Examines Impact of Medicaid Expansion on Postpartum Care.
• AHRQ in the Professional Literature.

Many Clinically Necessary Radiology Exams Remain Unscheduled After 30 Days

An AHRQ-funded analysis found that 7 percent of nearly 495,000 radiology orders remained unscheduled 30 days after orders were made. Two physician reviewers who then assessed a subset of 700 randomly selected unscheduled orders found 87 percent of bone density exams and 67 percent of mammograms were clinically necessary. They also found that clinically unnecessary orders, such as duplicate orders for the same exam, may inadvertently be scheduled and performed, which could negatively impact the quality, safety and experience of care for patients. Access the abstract of the study, published in the Journal of the American College of Radiology. 

Use of Osteoarthritis Decision Aids Led to More Hip, Knee Replacement Surgeries

Osteoarthritis patients who used decision aids were about twice as likely or more to have knee or hip replacement surgery within six months of discussing options with their physician, according to a study partially funded by AHRQ and published in Health Affairs. Researchers analyzed 2012–15 data for about 5,700 patients within the High Value Healthcare Collaborative, a learning network representing 10 health systems nationwide. The decision aids were video or Web-based tools used by patients and physicians to discuss tradeoffs and benefits of treatment options. While previous research from single-system trials has generally shown patients using decision aids tend to choose more conservative treatment options, the study’s authors suggested healthcare systems that use decision aids in hip and knee osteoarthritis consultations should not expect fewer surgeries. Access the abstract. 

Nominations Due Feb. 28 for Healthcare Cost and Utilization Project Outstanding Article of the Year

Nominations are being accepted for the 2019 Healthcare Cost and Utilization Project (HCUP) Outstanding Article of the Year Award. The annual award recognizes peer-reviewed journal articles that used the HCUP databases to explore and address healthcare research topics and issues. Researchers may self-nominate or be nominated by a colleague or others. Awards will be presented during an HCUP session at AcademyHealth’s 2020 Annual Research Meeting, which will be held June 13–16 in Boston. Complimentary registration, transportation and accommodations will be provided. One clinical winner and one policy winner will be chosen. The nomination period will close Feb. 28 at 11:59 p.m. ET. Access more information. Email questions to HCUPPres@us.ibm.com. 

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:

• Analysis of Paediatric Long-Term Ventilation Incidents in the Community.
• Assessment of Unintentional Duplicate Orders by Emergency Department Clinicians Before and After Implementation of a Visual Aid in the Electronic Health Record Ordering System.

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 Examines Impact of Medicaid Expansion on Postpartum Care

A study of postpartum care in two states found that Colorado’s 2014 Medicaid expansion improved postpartum coverage retention and access to outpatient care among new mothers compared with Utah, which did not expand Medicaid. Using Medicaid claims data from 2013 to 2015, researchers found the impact of Medicaid expansion was largest among women who had significant complications during delivery. New mothers in Colorado with complications had nearly 50 percent more postpartum Medicaid-financed outpatient visits compared with similarly complicated deliveries in Utah. Researchers noted Utah expanded its Medicaid program through the Affordable Care Act following the passage of a 2018 ballot initiative. Access the abstract of the study, published in the journal Health Affairs.

AHRQ in the Professional Literature

Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study. Chandanabhumma PP, Fetters MD, Pagani FD, et al. JMIR Res Protoc 2020 Jan 7;9(1):e14701. Access the abstract on PubMed®. 

California's new gold rush: marketplace enrollees switch to gold-tier plans in response to insurance premium changes. Rasmussen PW, Rice T, Kominski GF. Health Aff (Millwood) 2019 Nov;38(11):1902-10. Access the abstract on PubMed®. 

Power of a learning network in congenital heart disease. Anderson JB, Brown DW, Lihn S, et al. World J Pediatr Congenit Heart Surg 2019 Jan;10(1):66-71. Access the abstract on PubMed®.

Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid expansion. Angier H, Ezekiel-Herrera D, Marino M, et al. J Health Care Poor Underserved 2019;30(1):116-30.  Access the abstract on PubMed®.

Data omission by physician trainees on ICU rounds. Artis KA, Bordley J, Mohan V, et al. Crit Care Med 2019 Mar;47(3):403-9. Access the abstract on PubMed®.   

Parent empowerment in pediatric healthcare settings: a systematic review of observational studies. Ashcraft LE, Asato M, Houtrow AJ, et al. Patient 2019 Apr;12(2):199-212. Access the abstract on PubMed®. 

Longer-term direct and indirect effects of infant rotavirus vaccination across all ages in the United States in 2000-2013: analysis of a large hospital discharge data set. Baker JM, Tate JE, Steiner CA, et al. Clin Infect Dis 2019 Mar 5;68(6):976-83. Access the abstract on PubMed®.

Keeping your guard up: hypervigilance among urban residents affected by community and police violence. Smith NA, Voisin DR, Yang JP, et al. Health Aff (Millwood) 2019 Oct;38(10):1662-9. Access the abstract on PubMed®.