AHRQ-Commissioned Report Provides Overview of Federal Research on Health Services and Primary Care

AHRQ Stats

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Today's Headlines:

• AHRQ-Commissioned Report Provides Overview of Federal Research on Health Services and Primary Care.
• Telemedicine Use Influenced by Factors Such as Patient Age, Internet Access.
• New Perspective Identifies Pharmacy-Related Safety Concerns During COVID-19 Pandemic.
• Successful Vaginal Deliveries Possible Among Women Who’ve Had Multiple Previous Cesarean Sections.
• AHRQ in the Professional Literature.

AHRQ-Commissioned Report Provides Overview of Federal Research on Health Services and Primary Care

An independent study mandated by Congress and commissioned by AHRQ has concluded that federal investments in health services research (HSR) and primary care research (PCR) are integral to the nation’s healthcare system. The study was conducted by the RAND Corp., which analyzed HSR and PCR investment funded between 2011 and 2018 among eight HHS agencies and the Department of Veterans Affairs. It concluded there was minimal research overlap between agencies while identifying gaps and proposing recommendations for maximizing the outcomes, value and impact of research investments. The study’s authors suggested steps for improving the relevance and timeliness of HSR and PCR, maximizing the impact of research findings and encouraging research innovation. Access the report and an AHRQ Views blog post by agency Director Gopal Khanna, M.B.A.

Telemedicine Use Influenced by Factors Such as Patient Age, Internet Access

Patients are less likely to schedule video- and telephone-based telehealth appointments if they’re 65 or older or live in neighborhoods with limited internet access, according to an AHRQ-funded study. Meanwhile, logistical barriers such as paid parking and long travel distances increased the use of telehealth visits. Researchers reviewed more than 2.1 million primary care appointments scheduled via online portals by more than 1.1 million patients in Northern California between 2016 and 2018. They found 86 percent of primary care appointments were scheduled as office visits. The remaining 14 percent were scheduled as telemedicine visits, with 7 percent of those conducted by video. While most patients still preferred in-person visits, researchers identified mobile telehealth services as an effective way of providing healthcare access to individuals facing barriers to in-person appointments. Access the abstract of the study published in JAMA Network Open.

New Perspective Identifies Pharmacy-Related Safety Concerns During COVID-19 Pandemic

A new Perspective from AHRQ’s Patient Safety Network (PSNet) explores issues related to medication safety and the prevention of medication errors during the COVID-19 pandemic. The pandemic has created several challenges, authors noted, including medication shortages, changes to the pharmacy workflow, a changing evidence base associated with treatment complications and limited availability of personal protective equipment. The perspective identifies resources to address current challenges. The perspective is part of PSNet’s ongoing effort to highlight new resources related to patient safety. Articles highlighted this week include:

• COVID-19: patient safety and quality improvement skills to deploy during the surge.
• A sociotechnical framework for safety-related electronic health record research reporting: the SAFER reporting framework.
• A systems approach to analyzing and preventing hospital adverse events.

Access PSNet’s current issue or recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Successful Vaginal Deliveries Possible Among Women Who’ve Had Multiple Previous Cesarean Sections

Women who had two previous cesarean section deliveries who attempted a vaginal birth had a 39 percent chance of a successful vaginal birth, according to an AHRQ-funded study. The study, published in Obstetrics & Gynecology, found that these labor attempts were associated with a modest increase in risks to newborns but no change in risks to mothers. The authors reviewed records of about 1,200 women in California who attempted to deliver a baby after two previous cesarean deliveries. The study also found that teaching hospitals and hospitals with higher levels of care in their neonatal intensive care units, more midwife involvement and less litigious environments were more likely to have patients deliver vaginally after two C-sections. Access the abstract.

AHRQ in the Professional Literature

Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes. Dworsky JQ, Childers CP, Copeland T, et al. Am Surg 2019 Oct;85(10):1089-93. Access the abstract on PubMed®.

The policy and practice legacy of the New Jersey Medicaid ACO Demonstration Project. DeLia D, Yedidia MJ. J Ambul Care Manage 2020 Jan/Mar;43(1):2-10. Access the abstract on PubMed®.

Stakeholder perspectives on the biopsychosocial and spiritual realities of living with ALS: implications for palliative care teams. Kukulka K, Washington KT, Govindarajan R, et al. Am J Hosp Palliat Care 2019 Oct;36(10):851-7. Epub 2019 Mar 3. Access the abstract on PubMed®.

Missed nursing care during labor and birth and exclusive breastfeeding during hospitalization for childbirth. Simpson KR, Lyndon A, Spetz J, et al. MCN Am J Matern Child Nurs 2020 Jun 9. [Epub ahead of print.]  Access the abstract on PubMed®.

The quality of surgical care at hospitals associated with America's highest-rated medical centers. Sheetz KH, Chhabra K, Nathan H, et al. Ann Surg 2020 May;271(5):862-7. Access the abstract on PubMed®.

National trends in the safety performance of electronic health record systems from 2009 to 2018. Classen DC, Holmgren AJ, Co Z, et al. JAMA Netw Open 2020 May;3(5):e205547. Access the abstract on PubMed®.

Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool. Simione M, Sharifi M, Gerber MW, et al. Health Qual Life Outcomes 2020 Jun 11;18(1):179. Access the abstract on PubMed®.

Utilization trends, outcomes, and cost in minimally invasive lobectomy. Subramanian MP, Liu J, Chapman WC, Jr., et al. Ann Thorac Surg 2019 Dec;108(6):1648-55. Epub 2019 Aug 7. Access the abstract on PubMed®.