Study Examines Balancing Cost Containment, Quality Care for Surgeries at Children’s Hospitals

AHRQ Stats: Increased Suicide Rates in Rural Areas

From 1999 to 2015, suicide rates among American Indians and Alaska Natives in nonmetropolitan areas increased from about 21 to 34 per 100,000 people. Rates also increased among whites, from 17 to 25 per 100,000, and among blacks, from 7 to 8 per 100,000. (Source: AHRQ 2016 National Healthcare Quality and Disparities Report, Chartbook on Rural Health Care.)

Today's Headlines:

• Study Examines Balancing Cost Containment, Quality Care for Surgeries at Children’s Hospitals.
• Combining Data From Various Sources Provides Model for Examining U.S. Health Systems.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Study Examines Balancing Cost Containment, Quality Care for Surgeries at Children’s Hospitals

More research is needed to determine how children’s hospitals can keep costs in check while maintaining high-quality specialty surgical care, according to an AHRQ-funded article based on data from AHRQ’s Healthcare Cost and Utilization Project Kids’ Inpatient Database. Researchers reviewed data from 2000 to 2009 identifying all cases of common pediatric surgical procedures. They concluded that the proportion of common surgeries performed at children’s hospitals was outpacing the proportion of surgeries at non-children’s hospitals, despite lack of evidence of higher quality. Costs for certain procedures, meanwhile, were higher at children’s hospitals than non-children’s hospitals, leading to overall growth in the cost of children’s surgery. Access the abstract.

Combining Data From Various Sources Provides Model for Examining U.S. Health Systems

No single national data source provides a complete picture of U.S. health systems, but AHRQ’s Comparative Health System Performance (CHSP) initiative provides an early model of how data from different sources can be combined to support policy research, a new study found. The CHSP initiative was developed to explore how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. The new study, published in eGEMS, analyzed five national data sources that describe systems’ members (e.g., hospitals, physicians) and relationships among them (e.g., hospital ownership of physician groups). Researchers concluded that CHSP provides a model for combining data from different sources despite variations in content, linkages across data sources and collection methods.

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:

• Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study.
• Effect of standardized handoff curriculum on improved clinician preparedness in the intensive care unit: a stepped-wedge cluster randomized clinical trial.
• America's Hospitals: Improving Quality and Safety—The Joint Commission's Annual Report 2017.

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

ICU team composition and its association with ABCDE implementation in a quality collaborative. Costa DK, Valley TS, Miller MA, et al. J Crit Care 2017 Sep 28;44:1-6. [Epub ahead of print.] Access the abstract on PubMed®.

The fate of FDA postapproval studies. Woloshin S, Schwartz LM, White B, et al. N Engl J Med 2017 Sep 21;377(12):1114-17. Access the abstract on PubMed®.

Defining and measuring diagnostic uncertainty in medicine: a systematic review. Bhise V, Rajan SS, Sittig DF, et al. J Gen Intern Med 2018 Jan;33(1):103-15. Epub 2017 Sep 21. Access the abstract on PubMed®.

Reducing hospital readmissions through preferred networks of skilled nursing facilities. McHugh JP, Foster A, Mor V, et al. Health Aff (Millwood) 2017 Sep 1;36(9):1591-8. Access the abstract on PubMed®.

Organizational contributors to the variation in red blood cell transfusion practices in cardiac surgery: survey results from the state of Michigan. Camaj A, Zahuranec DB, Paone G, et al. Anesth Analg 2017 Sep;125(3):975-80. Access the abstract on PubMed®.

Moving to a more level playing field: the need for risk adjustment of publicly reported hospital CLABSI performance. Talbot TR. Infect Control Hosp Epidemiol 2017 Sep;38(9):1025-6. Access the abstract on PubMed®.

Evidence-based approaches to breaking down language barriers. Squires A. Nursing 2017 Sep;47(9):34-40. Access the abstract on PubMed®.

The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology. Jackson SS, Leekha S, Magder LS, et al. Infect Control Hosp Epidemiol 2017 Sep;38(9):1019-24. Epub 2017 Jul 3. Access the abstract on PubMed®.