Medicaid Expansion Influenced Location of New General Internists

AHRQ Stats

Access more data on this topic in the associated research findings, plus additional AHRQ data infographics.

Today's Headlines:

• Medicaid Expansion Influenced Location of New General Internists.
• Clinician Burnout, Engagement Not Linked in One-Third of Physicians Surveyed.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Medicaid Expansion Influenced Location of New General Internists

States that did not expand Medicaid under the Affordable Care Act lost new general internists to 33 expansion states and the District of Columbia, according to an AHRQ-funded study published in Medical Care. The authors compared location choices for 160,842 new physicians in eight specialty groups before and after implementation of the expansion. They found that nonexpansion states lost 310 general internists to expansion states between 2014 and 2019—a change driven by choices among men and international medical graduates. The authors suggested that fewer general internists in states that did not expand Medicaid could affect access to care for all their residents irrespective of insurance coverage. Access the abstract.

Clinician Burnout, Engagement Not Linked in One-Third of Physicians Surveyed

An AHRQ-funded study published in the Journal of the American Board of Family Medicine challenges the perspective that clinician burnout reduces engagement with patients and negatively impacts care. One-third of clinicians surveyed self-reported either maintaining high engagement while experiencing high burnout or remaining minimally engaged while experiencing low burnout. When matched to patient feedback from tools such as AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, patients ranked clinicians who maintained high engagement while feeling burned out 7 percent higher on communication and 9 percent higher on overall scores than clinicians who reported lower engagement or burnout. 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:

• Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices.
• Implementing a watcher program to improve timeliness of recognition of deterioration in hospitalized children.
• Community discharge among post-acute nursing home residents: an association with patient safety culture?
• Implementation of patient safety structures and processes in the patient-centered medical home.

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

Language preference does not influence stroke patients' symptom recognition or emergency care time metrics. Zachrison KS, Natsui S, Luan Erfe BM, et al. Am J Emerg Med 2021 Feb;40:177-80. Epub 2020 Nov 2. Access the abstract on PubMed®.

A user-centered evaluation of medication therapy management alerts for community pharmacists: Recommendations to improve usability and usefulness. Snyder ME, Adeoye-Olatunde OA, Gernant SA, et al. Res Social Adm Pharm 2021 Aug;17(8):1433-43. Epub 2020 Nov 4. Access the abstract on PubMed^®

The effects of coding intensity in Medicare Advantage on plan benefits and finances. Jacobs PD, Kronick R. Health Serv Res 2021 Apr;56(2):178-87. Epub 2020 Nov 9. Access the abstract on PubMed^®.

Identifying trigger concepts to screen emergency department visits for diagnostic errors. Mahajan P, Pai CW, Cosby KS, et al. Diagnosis 2020 Nov 11. [Epub ahead of print.] Access the abstract on PubMed^®.

How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study. Jones LD, Grout RW, Gilbert AL, et al. BMC Health Serv Res 2021 Mar 20;21(1):253. Access the abstract on PubMed^®.

Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity. Smith JM, Lin H, Thomas-Hawkins C, et al. Int J Environ Res Public Health 2021 May 25;18(11):5623. Access the abstract on PubMed^®.

Integration of improvement and implementation science in practice-based research networks: a longitudinal, comparative case study. Davis MM, Gunn R, Kenzie E, et al. J Gen Intern Med 2021 Jun;36(6):1503-13. Epub 2021 Apr 14. Access the abstract on PubMed^®.

Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment. Herrin J, Abraham NS, Yao X, et al. JAMA Netw Open 2021 May;4(5):e2110703. Epub 2021 May 21. Access the abstract on PubMed^®.