Access to Pediatric Hospitals, Services Varies Based on Geography

AHRQ Stats: Medicare Payments for Falls

Medicare was the most common expected payer in 2017 for emergency department treatment of injuries due to falls (38 percent). (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #266: Overview of Emergency Department Visits Related to Injuries, by Cause of Injury, 2017.)

Today's Headlines:

• Access to Pediatric Hospitals, Services Varies Based on Geography.
• AHRQ Grantee Profile Highlights Work of Donald Likosky, Ph.D., To Improve Outcomes for Cardiac Surgery Patients.
• Medicare Advantage Readmission Rates Lower Than Traditional Medicare, But Difference Not Improving.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Access to Pediatric Hospitals, Services Varies Based on Geography

While most Americans live within a one-hour drive of a hospital that provides at least one type of pediatric care, some geographic areas have limited capacity that may saturate in times of high demand, according to a new AHRQ-funded study published in Pediatrics. Researchers used the novel Health Systems and Provider Database, funded by AHRQ’s Comparative Health System Performance Initiative, to examine how quickly the nation’s 70 million infants, children and adolescents can reach an appropriate level of hospital care for life-threatening illnesses or injuries. They found that only 50 percent of Americans lived in counties within one hour of a neonatal intensive care unit, only 40 percent within an hour of a pediatric emergency facility and just 36 percent within an hour of a pediatric intensive care unit. Access the abstract.

AHRQ Grantee Profile Highlights Work of Donald Likosky, Ph.D., To Improve Outcomes for Cardiac Surgery Patients

Check out AHRQ’s latest grantee profile featuring the work of Donald Likosky, Ph.D., head of the University of Michigan’s Section of Health Services Research and Quality in the Department of Cardiac Surgery in Ann Arbor. Dr. Likosky embeds in clinical teams so physicians and nurses can articulate a problem; he then uses health services research approaches to solve it. For Dr. Likosky, this means working alongside clinicians to study distinct factors that contribute to heart surgery outcomes. Access more about Dr. Likosky’s work as well as additional AHRQ profiles.

Medicare Advantage Readmission Rates Lower Than Traditional Medicare, But Difference Not Improving

A new AHRQ analysis finds that hospital readmission rates were lower for Medicare Advantage patients than they were for traditional Medicare patients, but the rate of difference did not change over time. The authors of the study, published in the American Journal of Managed Care, said their findings cast doubt on whether Medicare Advantage plans are spearheading improvements in the U.S. healthcare delivery system. Analyzing data from AHRQ’s Healthcare Cost and Utilization Project, the authors found significantly lower all-cause readmission rates among Medicare Advantage enrollees than among those enrolled in traditional Medicare in 2009 and 2014, but also found that the difference in readmission rates between these types of Medicare did not change over time. 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:

• Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study.
• Bias and racism teaching rounds at an academic medical center.
• Home health staff perspectives on infection prevention and control: implications for Coronavirus Disease 2019.

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

Low-value care and clinician engagement in a large Medicare shared savings program ACO: a survey of frontline clinicians. Markovitz AA, Rozier MD, Ryan AM, et al. J Gen Intern Med 2020 Jan;35(1):133-41. Epub 2019 Nov 8. Access the abstract on PubMed®.

Cost sharing and utilization of postpartum intrauterine devices and contraceptive implants among commercially insured women. Moniz MH, Soliman AB, Kolenic GE, et al. Womens Health Issues 2019 Nov-Dec;29(6):465-70. Epub 2019 Sep 5. Access the abstract on PubMed®.

Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study. Nanji KC, Merry AF, Shaikh SD, et al. BMJ Open 2020 Jun 30;10(6):e038313. Access the abstract on PubMed®.

Non-infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients. Fischer MA, Mahesri M, Lii J, et al. Health Aff 2020 Feb;39(2):280-8. Access the abstract on PubMed®.

Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities. Hong I, Goodwin JS, Reistetter TA, et al. JAMA Netw Open 2019 Dec 2;2(12):e1916646. Access the abstract on PubMed®.

An examination of the barriers to and facilitators of implementing nurse-driven protocols to remove indwelling urinary catheters in acute care hospitals. DePuccio MJ, Gaughan AA, Sova LN, et al. Jt Comm J Qual Patient Saf 2020 Dec;46(12):691-8. Epub 2020 Sep 2. Access the abstract on PubMed®.

Automated identification of adults at risk for in-hospital clinical deterioration. Escobar GJ, Liu VX, Schuler A, et al. N Engl J Med 2020 Nov 12;383(20):1951-60. Access the abstract on PubMed®.

Persistent hypertension in children and adolescents: a 6-year cohort study. Kaelber DC, Localio AR, Ross M, et al. Pediatrics 2020 Oct;146(4): e20193778. Epub 2020 Sep 18. Access the abstract on PubMed®.