New AHRQ Report: Quality of Care and Patient Safety Are Improving, Particularly for Hospital Care, Although More Work Remains

AHRQ Stats: Employee Health Coverage

Among employees at private companies with fewer than 100 workers, about 60 percent were offered health insurance in 2013, down from 68 percent in 2008. Among the same workforce during that time period, the percentage of employees who had a deductible as part of their insurance rose from 71 percent to 79 percent. (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief #452: Employees in Smaller Private-Sector Firms: Trends in Offers, Enrollment Rates, and Deductibles, by Firm Size, 2008-2013.)

Today's Headlines

1. New AHRQ Report: Quality of Care and Patient Safety Are Improving, Particularly for Hospital Care, Although More Work Remains.
2. Rates of Choosing Employer Health Insurance No Different for Adults With Mental Disorders.
3. AHRQ WebM&M Features Patient Safety Expert Lucian Leape, M.D., on Surgical Checklists.
4. Register Now: May 7 AHRQ Webinar on Assessing Patient Health Information Needs.
5. Register Now: May 18 Webinar on Overcoming Barriers to Shared Decision-Making.
6. AHRQ in the Professional Literature.

1. New AHRQ Report: Quality of Care and Patient Safety Are Improving, Particularly for Hospital Care, Although More Work Remains

The overall quality of health care and patient safety are improving, particularly for hospital care and for measures that are publicly reported by the Centers for Medicare & Medicaid Services, according to AHRQ's newly released 2014 National Healthcare Quality and Disparities Report. Hospital care was safer in 2013 than in 2010, with 17 percent fewer harms to patients and an estimated 1.3 million fewer hospital-acquired conditions, 50,000 fewer deaths, and $12 billion in cost savings over three years (2011, 2012, 2013). However, quality is still far from optimal, with millions of patients harmed by the care they receive, and only 70 percent of recommended care being delivered across a broad array of quality measures. A few disparities among racial groups for services such as childhood vaccinations have been reduced to zero; however, much additional work remains to address a broad range of other disparities affecting quality of care. This year's report has been consolidated and now tracks performance measures that align with HHS' National Quality Strategy. Chartbooks on specific topics such as patient safety and care coordination will be issued in coming months to provide more detailed information and easy-to-understand slides that can be downloaded for presentations. Complimentary copies of the report are available online.

2. Rates of Choosing Employer Health Insurance No Different for Adults With Mental Disorders

People with mental disorders are no more or less likely than other people to enroll in health insurance plans offered by their employers, a new AHRQ study found. The article and abstract, "The Take-up of Private Health Insurance Among Americans with Mental Disorders: Implications for Health Care Reform," were published online March 17 in the Journal of Behavioral Health Services & Research. Study results suggest that takeup rates in Affordable Care Act marketplaces by those with or without mental disorders may be similar. The study, authored by AHRQ's Samuel H. Zuvekas, Ph.D., used data from AHRQ's 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and takeup of employer-sponsored insurance among adults ages 27 to 54. Those with mental disorders were substantially less likely to have access to insurance coverage through an employer, making Affordable Care Act marketplaces particularly important to the large number of Americans with mental disorders who lack access to other coverage, the article noted.

3. AHRQ WebM&M Features Patient Safety Expert Lucian Leape, M.D., on Surgical Checklists

The current issue of AHRQ WebM&M features an interview about patient safety checklists with Lucian Leape, M.D., adjunct professor of health policy at the Harvard School of Public Health and chairman of the Lucian Leape Institute of the National Patient Safety Foundation. Dr. Leape is a health policy innovator whose groundbreaking research has focused on patient safety and quality of care. The interview is based on a study that reported that an effort to mandate surgical checklists in Canada had no beneficial effect. The issue also features another interview on the same topic with David Urbach, M.D., professor of surgery and health policy management and evaluation at the University of Toronto. The Spotlight Case is about a woman who was admitted to a hospital with a presumed transient ischemic attack and possible gastrointestinal bleeding. During her second day in the hospital, she was found unconscious and in cardiac arrest.

4. Register Now: May 7 AHRQ Webinar on Assessing Patient Health Information Needs

AHRQ is hosting a webinar on May 7 from 1:30 to 3 p.m. ET to discuss projects that studied the identification of consumers' personal health information management practices and the context in which these practices occur to inform the development of consumer health information technology tools. Personal health information management practices describe how consumers access, organize and use their health information. The projects described in this webinar highlight tools to communicate safety concerns among hospitalized patients, tools to assist patients with diabetes and asthma management, and physical features of patients' homes that have an impact on personal health information management. Registration is open.

5. Register Now: May 18 Webinar on Overcoming Barriers to Shared Decision-Making

AHRQ will host a webinar on May 18 from 1 to 2:30 p.m. ET to discuss barriers to implementing shared decision-making and strategies for overcoming these barriers. The webinar will address:

• Barriers to shared decision-making from both the patient and provider perspectives.
• Strategies for overcoming barriers to shared decision-making in clinical practice.
• Insights AHRQ gained during the development of the SHARE Approach, a five-step process for dialogue with patients, to facilitate implementation of shared decision-making.

Determination of continuing education credit through Professional Education Services Group is pending. Registration is open.

6. AHRQ in the Professional Literature

Curtis JR, Wright NC, Xie F, et al. Use of health plan combined with registry data to predict clinical trial recruitment. Clin Trials 2014 Feb;11(1):96-101. Epub 2013 Dec 17. Select to access the abstract on PubMed®.

Barocas DA, Chen V, Cooperberg M, et al. Using a population-based observational cohort study to address difficult comparative effectiveness research questions: the CEASAR study. J Comp Eff Res 2013 Jul;2(4):445-60. Select to access the abstract on PubMed®.

Tan A, Kuo YF, Goodwin JS. Potential overuse of screening mammography and its association with access to primary care. Med Care 2014 Jun;52(6):490-5. Select to access the abstract on PubMed®.

Bramble JD, Abbott AA, Fuji KT, et al. Patient safety perspectives of providers and nurses: the experience of a rural ambulatory care practice using an EHR with E-prescribing. J Rural Health 2013 Fall;29(4):383-91. Epub 2013 Mar 12. Select to access the abstract on PubMed®.

St Peter WL, Sozio SM, Shafi T, et al. Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months. BMC Nephrol 2013 Nov 12;14:249. Select to access the abstract on PubMed®.

Shafi T, Sozio SM, Bandeen-Roche KJ, et al. Predialysis systolic BP variability and outcomes in hemodialysis patients. J Am Soc Nephrol 2014 Apr;25(4):799-809. Epub 2014 Jan 2. Select to access the abstract on PubMed®.

Stundner O, Danninger T, Chiu YL, et al. Rheumatoid arthritis vs osteoarthritis in patients receiving total knee arthroplasty: perioperative outcomes. J Arthroplasty 2014 Feb;29(2):308-13. Epub 2013 Jun 12. Select to access the abstract on PubMed®.

Olfson M, Kroenke K, Wang S, et al. Trends in office-based mental health care provided by psychiatrists and primary care physicians. J Clin Psychiatry 2014 Mar;75(3):247-53. Select to access the abstract on PubMed®.