Electronic Newsletter

June 1, 2012

AHRQ Stats

Diagnostic and preventive dental procedures increased as a percentage of all procedures between 1999 and 2009, while restorative, prosthetic, endodontic and orthodontic procedures decreased. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #368: Dental Procedures, United States, 2009.]

Today's Headlines

1. New AHRQ report finds teamwork and follow-up as strengths of medical offices but work pressure and pace a problematic.
2. New study projects savings by Affordable Care Act to individual health insurance policyholders.
3. New patient decision aid and other resources available on osteoporosis medications.
4. New resources summarize evidence on the use of adjunctive devices for acute coronary syndrome.
5. AHRQ's Health Care Innovations Exchange focuses on coordinating community care for seniors.
6. New podcast series about the AHRQ Quality Indicators™ Toolkit for hospitals.
7. Call for papers for special issue of Health Services Research on Mixed Methods in Healthcare Delivery System Research.
8. AHRQ in the professional literature.

1. New AHRQ Report Finds Teamwork and Follow-Up as Strengths of Medical Offices but Work Pressure and Pace are Problematic

Teamwork and patient care tracking/follow-up are strengths for medical offices, but work pressure and pace are areas for improvement, according to new results from the AHRQ Medical Office Survey on Patient Safety Culture. Most (84 percent) medical office staff feel they have good teamwork among staff and providers and that the office follows up with patients appropriately (82 percent). But only 46 percent of staff rated the work pressure and pace in their office positively. The first edition of the Medical Office Survey on Patient Safety Culture: 2012 User Comparative Database Report provides results from 23,679 staff from 934 U.S. medical offices. The report helps medical offices compare their patient safety culture scores with other medical offices. It contains detailed comparative data on the survey by number of providers, specialty, ownership, region, and by staff position. Select to access the survey that can be used by medical offices, health systems and researchers to assess the opinions of medical office staff about patient safety issues and overall quality of care. It measures 10 areas of patient safety culture as well as overall ratings on quality and patient safety.

2. New Study Projects Savings by Affordable Care Act to Individual Health Insurance Policyholders

People with private individual health insurance would likely save $280 a year in out-of-pocket spending for medical care, including prescription drugs, under the Affordable Care Act (ACA), according to an AHRQ study published May 16 online by the journal Health Affairs. ACA would decrease out-of-pocket spending by $589 for people ages 55 to 64 and by $535 for low-income adults. The study also estimates that under ACA, the percentage of individually insured adults whose out-of-pocket spending exceeds $6,000 a year would fall from 2.6 percent to 0.6 percent. The study projected an individual's likely annual savings from 2001 to 2008, based on data from AHRQ's nationally representative Medical Expenditure Panel Survey, which collects data on how Americans use and pay for health care. About 11 million nonelderly Americans had private individual health insurance in 2009. Select to access the abstract.

3. New Patient Decision Aid and Other Resources Available on Osteoporosis Medications

A new online interactive patient decision aid is now available from AHRQ's Effective Health Care Program. The decision aid helps patients prepare to talk with their clinician about osteoporosis medications and treatment options. This online tool is accompanied by a new consumer summary, Reducing the Risk of Bone Fracture: A Review of the Research for Adults with Low Bone Density, which describes low bone density and how it contributes to bone fracture, and discusses various treatment options. A clinician summary, a CME/CE activity, and a faculty slide set are also available. These resources are based on the recently released research review, Treatment to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis: Update of a 2007 Report. Approximately 52 million Americans are affected by osteoporosis or low bone density, and more than 2 million fractures occurred in 2010.

4. New Resources Summarize Evidence on the Use of Adjunctive Devices for Acute Coronary Syndrome

A new set of clinician resources from AHRQ's Effective Health Care Program summarize the evidence on the comparative effectiveness, benefits and harms of adjunctive devices to prevent or remove blood clots in patients with acute coronary syndrome who are undergoing percutaneous coronary interventions of heart arteries. Current evidence on the use of these devices is too limited to draw firm conclusions about the benefits and harms of one adjunctive device over another. However, catheter aspiration thrombectomy reduced the occurrence of major negative cardiovascular events among patients who suffered a heart attack caused by a blockage in a coronary artery, the evidence showed. The new resources include a clinician summary, CME/CE activity, and faculty slide set, based on the recently released research review, Comparative Effectiveness of Adjunctive Devices to Remove Thrombi or Protect Against Distal Embolization in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention of Native Vessels.

5. AHRQ's Health Care Innovations Exchange Focuses on Coordinating Community Care for Seniors

Programs that provide care coordination and support to seniors and to adults with serious mental illness reduced hospital and nursing home admissions and emergency department visits and are featured in the May 23 issue of AHRQ's Health Care Innovations Exchange. One such program is the Tri-County Rural Health Network, a nonprofit community development organization that works with low-income individuals in the Mississippi Delta. The program uses outreach workers known as "community connectors" to identify Medicaid-eligible residents who have unmet, long-term health care needs. These workers arrange for residents to receive appropriate home and community-based care, such as medical equipment delivery, home health aide visits, and meals. Over three years, none of the participants needed to be placed in a nursing home. The program also reduced health care costs and generated a return on investment. Read more profiles of innovations related to care coordination on the Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.

6. New Podcast Series about the AHRQ Quality Indicators™ Toolkit for Hospitals

AHRQ is releasing a series of seven audio interviews focused on the use of quality improvement tools in the AHRQ Quality Indicators™ Toolkit for Hospitals. The toolkit is a free resource to guide hospitals through the process of using the AHRQ Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs) to improve care. The first interview in this series features Donna Farley, adjunct senior health policy analyst at the RAND Corporation, speaking about how hospital teams can adapt and use the toolkit to support their quality improvement initiative. Select to download Getting Started with the AHRQ QI Toolkit. (Audio file and transcript are available.) Future podcasts will address the following topics:

• Analyzing Your IQI and PSI Rates.
• Using the Documentation and Coding Tool.
• Identifying Your Improvement Priorities.
• Analyzing Your Barriers and Strategy Options.
• Implementing Changes to Improve Performance on the IQI or PSI Measures.
• Achieving Sustainable Improvements.

Select to download the AHRQ Quality Indicators™ Toolkit for Hospitals. Select to access the slide presentations and an audio recording from an introductory Web conference about the toolkit.

7. Call for Papers for Special Issue of Health Services Research on Mixed Methods in Healthcare Delivery System Research

AHRQ and Health Services Research are partnering to publish a special issue on Mixed Methods in Healthcare Delivery Systems Research. This type of research is defined as research that combines and systematically integrates quantitative and qualitative methods in a single study to obtain a fuller picture and deeper understanding of a phenomenon. The aim of the special issue is to provide researchers, funders, and policymakers with a better understanding of how mixed methods studies may contribute to health services research and to promote and facilitate the expanded use of mixed methods designs in delivery system research. This issue will consist of reports on results from exemplary mixed-methods studies and papers that advance an understanding of principles underlying mixed methods research or address specific methodological challenges in this type of research. Deadline to submit is October 15. Select to submit papers.

8. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Access to the abstracts may be blocked because of firewalls or specific settings on individual computer systems. If you are having problems, ask your technical support staff for possible remedies.

Callaghan B, McCammon R, Kerber K, et al. Tests and expenditures in the initial evaluation of peripheral neuropathy. Arch Intern Med 2012 Jan 23; 172(2):127-32. Select to access the abstract on PubMed.®

Kralewski JE, Zink T, Boyle R. Factors influencing electronic clinical information exchange in small medical group practices. J Rural Health 2012 Jan; 28(1):28-33. Select to access the abstract on PubMed.®

Chima RS, Schoettker PJ, Varadarajan KR, et al. Reduction in hypoglycemic events in critically ill patients on continuous insulin following implementation of a treatment guideline. Qual Manag Health Care 2012 Jan; 21(1):20-8. Select to access the abstract on PubMed.®

Morrison F, Shubina M, Turchin A. Lifestyle counseling in routine care and long-term glucose, blood pressure, and cholesterol control in patients with diabetes. Diabetes Care 2012 Feb; 35(2):334-41. Select to access the abstract on PubMed.®

DeVoe JE, Westfall N, Crocker S, et al. Why do some eligible families forego public insurance for their children? A qualitative analysis. Fam Med 2012 Jan; 44(1):39-46. Select to access the abstract on PubMed.®

Hollingsworth JM, Saint S, Sakshaug JW, et al. Physician practices and readiness for medical home reforms: policy, pitfalls, and possibilities. Health Serv Res 2012 Feb; 47(1 Pt 2):486-508. Select to access the abstract on PubMed.®

DeVoe JE, Tillotson CJ, Wallace LS, et al. Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling. Matern Child Health J 2012 Feb; 16(2):306-15. Select to access the abstract on PubMed.®

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Current as of June 2012

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Internet Citation:

AHRQ Electronic Newsletter, June 1, 2012, Issue 344. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews344.htm

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