With Mergers and Acquisitions, More Than Half of U.S. Physicians Now Affiliated With Health Systems

AHRQ Stats: Emergency Care Covered by Medicaid

In 2017, Medicaid covered the largest share of hospital emergency department visit costs for patients with suicidal ideation, attempt or self-harm (39 percent), bipolar and related disorders (37 percent) and alcohol-related disorders (34 percent). (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #257: Costs of Emergency Department Visits for Mental and Substance Use Disorders in the United States, 2017.)

Today's Headlines:

• With Mergers and Acquisitions, More Than Half of U.S. Physicians Now Affiliated With Health Systems.
• AHRQ Views Blog—Open Source Code for PRISM App Supports Advances in Reporting, Using PRO Data.
• Highlights From AHRQ’s Patient Safety Network.
• New Electronic Patient-Reported Outcomes Toolkit Available.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

With Mergers and Acquisitions, More Than Half of U.S. Physicians Now Affiliated With Health Systems

Consolidation of physicians and hospitals into health systems increased substantially from 2016 to 2018, according to a study conducted by AHRQ and published in Health Affairs. The study found that 51 percent of U.S. physicians were affiliated with health systems in 2018 compared with 40 percent in 2016. During the same period, the share of primary care physicians affiliated with health systems increased from 38 percent to 49 percent, and the share of hospitals affiliated with systems increased from 70 percent to 72 percent. Of 50 mergers and acquisitions that occurred, most involved relatively smaller systems, with only a few hospitals being acquired by larger systems. For-profit and church-operated systems had the largest increases in system size. This analysis was based on data from AHRQ’s Compendium of U.S. Health Systems, the nation’s first publicly available database of U.S. health systems. Access the study abstract.

AHRQ Views Blog—Open Source Code for PRISM App Supports Advances in Reporting, Using PRO Data

The use of an innovative tool to advance the collection and use of patient-reported outcome (PRO) data is the subject of a new AHRQ Views blog post by Director Gopal Khanna, M.B.A. AHRQ has released the open-source code used to develop the PRISM™ app, a mobile app that guides patients through questions about their health status and enables PRO data to be exported in a standardized format so patients’ health status can be easily shared with providers during the clinical visit. The PRISM app won AHRQ’s Step Up App Challenge, and now appears to be ready for a bigger stage. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog”.

Highlights From AHRQ’s Patient Safety Network

A new primer from AHRQ’s Patient Safety Network (PSNet) highlights the well-established principles of diagnostic error and improving diagnostic accuracy related to COVID-19. As noted in the primer, delayed diagnosis of COVID-19 may lead to preventable transmissions, including exposed family members and health care workers, as well as delayed treatment. The primer, which will be updated over time to incorporate new evidence, is part of PSNet’s ongoing effort to highlight new resources related to patient safety. Articles highlighted in this week’s PSNet issue include:

• The safety of health care for ethnic minority patients: a systematic review.
• The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
• User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study.

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

New Electronic Patient-Reported Outcomes Toolkit Available

A new toolkit funded by AHRQ’s Digital Healthcare Research Program is available to help healthcare systems integrate electronic patient-reported outcomes (ePROs) into care delivery. The ePROs in Clinical Care toolkit provides evidence-based guidelines and strategies for the use of PROs that are collected electronically, rather than through traditional pen-and-paper methods. The toolkit is organized around three core topic areas where changes may be needed across the health systems: governance, integration and reporting. The resource is intended to support the growing use of ePROs in clinical care. The toolkit was developed through a grant awarded to the University of Washington. Access print and web versions of the toolkit.

New Research and Evidence From AHRQ

• Rapid evidence product: Retention Strategies for Medications for Addiction Treatment in Adults With Opioid Use Disorder.
• Systematic review: Care Interventions for People Living With Dementia and Their Caregivers.

AHRQ in the Professional Literature

Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children. Akincigil A, Mackie TI, Cook S, et al. Health Serv Res 2020 Aug;55(4):596-603. Epub 2020 Jun 21. Access the abstract on PubMed®.

Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017-2019. Atkins M, Castro I, Sharifi M, et al. Am J Public Health 2020 Jul;110(S2):S251-s7. Access the abstract on PubMed®.

Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure. Baik D, Reading M, Jia H, et al. Eur J Cardiovasc Nurs 2019 Apr;18(4):325-31. Epub 2019 Jan 25. Access the abstract on PubMed®.

Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks. Baker AW, Nehls N, Ilieş I, et al. BMJ Qual Saf 2020 Jun;29(6):517-20. Epub 2020 Apr 21. Access the abstract on PubMed®.

Development of an app to facilitate communication and shared decision-making with parents of febrile infants </=60 days old. Aronson PL, Politi MC, Schaeffer P, et al. Acad Emerg Med 2020 Jul 9. [Epub ahead of print.] Access the abstract on PubMed®.

Effects of practice turnover on primary care quality improvement implementation. Baron AN, Hemler JR, Sweeney SM, et al. Am J Med Qual 2020 Jan/Feb;35(1):16-22. Epub 2019 Apr 29. Access the abstract on PubMed®.

Factors associated with receipt of training among caregivers of older adults. Burgdorf J, Roth DL, Riffin C, et al. JAMA Intern Med 2019 Jun;179(6):833-5. Access the abstract on PubMed®.

Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults. Holden RJ, Campbell NL, Abebe E, et al. Res Social Adm Pharm 2020 Jan;16(1):54-61. Epub 2019 Feb 26. Access the abstract on PubMed®.