Black Women Diagnosed Far More Often Than White Women With Preeclampsia or Eclampsia

AHRQ Stats: Declines in Employer-Sponsored Insurance

The insurance enrollment rate for private-sector employees in states that expanded Medicaid fell by 7.1 percentage points from 2008 to 2015, while the decline was 4.5 percentage points in non-expansion states. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief 499, Trends in Enrollment, Offers, Eligibility and Take-Up for Employer-Sponsored Insurance: Private Sector, by State Medicaid Expansion Status, 2008-2015.)

Today's Headlines:

• Black Women Diagnosed Far More Often Than White Women With Preeclampsia or Eclampsia.
• Highlights From AHRQ’s Patient Safety Network.
• Study Finds Errors in Diagnosis of Spinal Epidural Abscess.
• New AHRQ Views Blog Post.
• Featured Case Study: AHRQ Tools Help Pennsylvania Residents Take an Active Role in Their Health Care.
• AHRQ in the Professional Literature.

Black Women Diagnosed Far More Often Than White Women With Preeclampsia or Eclampsia

The rates of preeclampsia and eclampsia—disorders that can cause high blood pressure, kidney and liver problems, or seizures during pregnancy—were 60 percent higher for black women than for white women in 2014, according to an AHRQ analysis of hospital births. The statistical brief also found the disorders were likely to be more severe among black women. Overall, hospital births involving preeclampsia and eclampsia increased by 21 percent from 2005 to 2014. In 2014, 5 percent of all hospital births—or nearly 177,000—were affected. Procedures such as cesarean section, blood transfusion, hysterectomy and ventilation were more common among women with preeclampsia and eclampsia, and the average length and cost of hospital stays involving these conditions were 70 percent higher than other deliveries. The U.S. Preventive Services Task Force has released a recommendation that all pregnant women be screened for preeclampsia. The task force is an independent, volunteer group of national experts in prevention and evidence-based medicine that makes recommendations about clinical preventive services such as screening tests, counseling services and preventive medications.

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:

• Prognosis of undiagnosed chest pain: linked electronic health record cohort study.
• The relationship between professional burnout and quality and safety in healthcare: a meta-analysis.
• Rates and characteristics of paid malpractice claims among US physicians by specialty, 1992–2014.

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 Finds Errors in Diagnosis of Spinal Epidural Abscess

New research has found that diagnostic errors were common among patients with spinal epidural abscesses. The research, published in an article in the American Journal of Medicine, was based on Department of Veterans Affairs health records of patients with the condition, which can lead to spinal compression and severe health problems if not treated. Reviewing records of 119 patients with spinal epidural abscesses, researchers found that 56 percent had experienced diagnostic error. Red flags that were frequently missed in the error cases included unexplained fever, neurological deficits with progressive or disabling symptoms, and infection. The study’s authors, funded in part by AHRQ, concluded that diagnostic errors resulted from inadequate patient histories, physical exams and test ordering. Access the abstract.

New AHRQ Views Blog Post

• Supporting Internists in Improving Primary Care.

Featured Case Study: AHRQ Tools Help Pennsylvania Residents Take an Active Role in Their Health Care

Hospitals and libraries across Pennsylvania are using AHRQ’s "Questions Are the Answer" patient engagement resources to encourage people to take an active role in their health care. Access the case study.

AHRQ in the Professional Literature

Eliminating composite bias in treatment effects estimates: applications to quality of life assessment. McCarthy IM. J Health Econ 2016 Dec;50:47-58. Epub 2016 Sep 13. Access the abstract on PubMed®.

Continuity of medication management in Medicaid patients with chronic comorbid conditions: an examination by mental health status. Farley JF, Hansen RA, Domino ME, et al. Gen Hosp Psychiatry 2017 Mar-Apr;45:25-31. Epub 2016 Dec 8. Access the abstract on PubMed®.

Statins in primary prevention: uncertainties and gaps in randomized trial data. Mansi IA. Am J Cardiovasc Drugs 2016 Dec;16(6):407-18. Access the abstract on PubMed®.

Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool. Inrig SJ, Higashi RT, Tiro JA, et al. Eval Program Plann 2017 Apr;61:113-24. Epub 2016 Nov 23. Access the abstract on PubMed®.

Adjusting health expenditures for inflation: a review of measures for health services research in the United States. Dunn A, Grosse SD, Zuvekas SH. Health Serv Res 2016 Nov 21. [Epub ahead of print.] Access the abstract on PubMed®.

Subsequent health-care utilization associated with early physical therapy for new episodes of low back pain in older adults. Karvelas DA, Rundell SD, Friedly JL, et al. Spine J 2017 Mar;17(3):380-9. Epub 2016 Oct 17. Access the abstract on PubMed®.

Towards improved drug allergy alerts: multidisciplinary expert recommendations. Topaz M, Goss F, Blumenthal K, et al. Int J Med Inform 2017 Jan;97:353-5. Epub 2016 Oct 6. Access the abstract on PubMed®.

Associations between relative value units and patient-reported back pain and disability. Gold LS, Bryan M, Comstock BA, et al. Gerontol Geriatr Med. 2017 Jan 16;3:2333721416686019. Access the abstract on PubMed®.