New Clinical Decision Support Resources Can Help Deliver Preventive Health Information to Patients

AHRQ Stats: Impact of Gender on Healthcare Premiums

Among companies where women accounted for 75 percent or more of the workforce, employer-sponsored healthcare coverage averaged $20,593 per family in 2018. Premiums averaged $18,875, meanwhile, where women represented less than 25 percent of the workforce. Women have higher healthcare expenses than men, which impacts the amount of healthcare premiums. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #525: Premiums and Employee Contributions to Employer-Sponsored Health Insurance by Workforce Gender and Firm Size, Private Industry, 2018.) 

Today's Headlines:

• New Clinical Decision Support Resources Can Help Deliver Preventive Health Information to Patients.
• Report on Hospital Births Measures Stay Rates and Related Outcomes Among Women With Substance Use Disorder.
• Medicaid Patients in Oregon Sought Primary Care, Not Emergency Department Visits, After Program Expansion.
• Highlights From AHRQ’s Patient Safety Network.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

New Clinical Decision Support Resources Can Help Deliver Preventive Health Information to Patients

AHRQ has released three new preventive health clinical decision support (CDS) resources that can be implemented in a patient-facing platform, such as a patient portal or health and wellness app. The resources are based on recommendations from the U.S. Preventive Services Task Force. Paired with implementation guides and a report on pilot testing, the resources are designed to help deliver patient-specific, preventive health information about abnormal blood glucose and type 2 diabetes screening, healthful diet and physical activity for heart disease prevention in adults, and statin use for the primary prevention of cardiovascular disease in adults. Visit CDS Connect to learn more about improving the quality of care through clinical decision support. 

Report on Hospital Births Measures Stay Rates and Related Outcomes Among Women With Substance Use Disorder

Almost 92,000 hospital deliveries in 2016 involved a mother with a substance use disorder (SUD), and deliveries involving opioids were far more common than those involving cocaine or other stimulants, a new AHRQ analysis shows. Previous research has shown babies born to mothers who use opioids or stimulants during pregnancy are often born prematurely and with low birth weights. Use of cocaine and other stimulants can cause maternal migraines and seizures, as well as lead to hypertensive crises. The new data were drawn from AHRQ’s Healthcare Cost and Utilization Project, a family of databases that features the largest collection of longitudinal hospital care data in the United States. According to the analysis, SUD-related deliveries involving opioids (7.6 per 1,000 deliveries) were more common than those involving cocaine (1.5 per 1,000) and other stimulants (2.8 per 1,000). The rate of SUD-related deliveries was higher for patients from rural areas (about 36 per 1,000 deliveries) than from urban areas (about 23 per 1,000). Access the statistical brief.  

Medicaid Patients in Oregon Sought Primary Care, Not Emergency Department Visits, After Program Expansion

Because Medicaid-covered patients tend to have high emergency department (ED) use rates, policymakers expected that Medicaid expansion under the Affordable Care Act (ACA) would result in higher ED use. But following the ACA’s Medicaid expansion in 2014, most patients covered under the program in Oregon sought primary care rather than care in EDs, an AHRQ-funded study in Medical Care found. Researchers used Medicaid enrollment data to identify about 213,000 Oregon patients continuously enrolled in the program during 2014 and 2015. Most newly and returning insured Medicaid enrollees sought primary care rather than ED services, and most became established with primary care, the analysis showed. The highest rate of ED use was among new patients who were continuously insured but lacked an established relationship with a primary care provider. These findings suggest the important role that continuity of care can play in lower ED use, as well as expanded access to health insurance, researchers concluded. 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:

• Hand-off bundle implementation associated with decreased medical errors and preventable adverse events on an academic family medicine in-patient unit: A pre-post study.
• Missed serious neurologic conditions in emergency department patients discharged with nonspecific diagnoses of headache or back pain.
• Patient and family engagement as a potential approach for improving patient safety: A systematic review.

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). 

New Research and Evidence From AHRQ

• Facilitating the Implementation of EPC Reports in Learning Health Systems Engaged in Quality Initiatives: an EPC Pilot Project on ADHD.

AHRQ in the Professional Literature

Social media vaccine websites: a comparative analysis of public and moderated websites. Shoup JA, Narwaney KJ, Wagner NM, et al. Health Educ Behav 2019 Jun;46(3):454-62. Epub 2018 Dec 29. Access the abstract on PubMed®.

Use of machine learning to identify follow-up recommendations in radiology reports. Carrodeguas E, Lacson R, Swanson W, et al. J Am Coll Radiol 2019 Mar;16(3):336-43. Epub 2018 Dec 29. Access the abstract on PubMed®.

Decreases in readmissions credited to Medicare's program to reduce hospital readmissions have been overstated. Ody C, Msall L, Dafny LS, et al. Health Aff (Millwood) 2019 Jan;38(1):36-43. Access the abstract on PubMed®.

Sustainment of Lean redesigns for primary care teams. Hung DY, Gray CP, Truong QA, et al. Qual Manag Health Care 2019 Jan/Mar;28(1):15-24. Access the abstract on PubMed®.

The effect of shared decisionmaking on patients' likelihood of filing a complaint or lawsuit: a simulation study. Schoenfeld EM, Mader S, Houghton C, et al. Ann Emerg Med 2019 Jul;74(1):126-36. Epub 2019 Jan 3. Access the abstract on PubMed®.

Health utilities and parental quality of life effects for three rare conditions tested in newborns. Simon NJ, Richardson J, Ahmad A, et al. J Patient Rep Outcomes 2019 Jan 22;3(1):4. Access the abstract on PubMed®.

Advancing the use of patient-reported outcomes in practice: understanding challenges, opportunities, and the potential of health information technology. Hsiao CJ, Dymek C, Kim B, et al. Qual Life Res 2019 Jun;28(6):1575-83. Epub 2019 Jan 25. Access the abstract on PubMed®.

Infections after pediatric ambulatory surgery: incidence and risk factors. Gerber JS, Ross RK, Szymczak JE, et al. Infect Control Hosp Epidemiol 2019 Feb;40(2):150-7. Access the abstract on PubMed®.