AHRQ News Now: sickle cell readmissions; 2018 National Healthcare Quality and Disparities Report; use of CT scans for kidney stones

AHRQ News Now

September 10, 2019, Issue #679

AHRQ Stats: Pediatric Hospital Care for Childbirth

Childbirth represented about 30 percent of pediatric hospital costs in 2016 yet constituted about 60 percent of pediatric hospitalizations that year. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #250: Costs of Pediatric Hospital Stays, 2016.)

Today's Headlines:

One-Third of Patients Discharged From Hospitals for Sickle Cell Disease Are Readmitted Within 30 Days

sickle cell

A new analysis from AHRQ estimates that one-third of 95,600 hospital stays specifically for sickle cell disease had a readmission within 30 days and cost a total of over $811.4 million in 2016. Hospital stays for sickle cell are 2.5 times as likely to result in a readmission as hospitalizations unrelated to the disease, according to the statistical brief from AHRQ’s Healthcare Cost and Utilization Project. Hospital stays related to sickle cell disease were 1.5 times as likely to be admitted from an emergency department and nearly four times more likely to be discharged against medical advice as unrelated stays. Half were for patients 18–34 years old, and nearly 90 percent were black patients. The new analysis, released to coincide with Sickle Cell Disease Awareness Month, supports the ongoing efforts of HHS’ Sickle Cell Initiative, which aims to transform the lives of people living with sickle cell disease by moving the most promising therapies safely into clinical trials within five to 10 years. Access resources provided as part of the initiative and learn about upcoming webinars.  

Annual Report on Healthcare Quality and Disparities Shows Some Progress, Includes Expanded Measures of Opioid Use

An updated annual report on the quality of the nation’s healthcare shows that between 2000 and 2017, improvement occurred in almost 70 percent of measures used to evaluate person-centered care. During the same period, 60 percent of patient safety measures improved while care affordability measures remained the same. Those are among the findings in the 2018 National Healthcare Quality and Disparities Report, which each year provides a comprehensive overview of healthcare quality in the general U.S. population. As in previous years, the report shows substantial disparities related to race, ethnicity, income and other factors. In support of HHS’ ongoing effort to defeat the opioid crisis, this year’s report includes six opioid measures to provide more information on the impact of opioid dependence on healthcare delivery and services. The additional measures include drug overdose death rates, adult opioid outpatient prescription fills and the percentage of adults with opioid use disorder. This year’s report also includes measures in three additional areas: cancer care, dementia and maternal morbidity and mortality. 

Study Details Evidence on When To Use CT Scans To Identify Kidney Stones

Younger patients with suspected kidney stones can generally avoid use of computerized tomography (CT) scans to identify the kidney stones, while older patients should get CT scans with a reduced-radiation dose, according to AHRQ-funded research. The findings are based on 29 clinical scenarios under which patients with suspected kidney stones should get CT, ultrasound or no imaging at all. Researchers convened a panel of physician experts from the American College of Emergency Physicians, the American College of Radiology and the American Urology Association. There are more than 2 million annual emergency department visits for kidney stone pain in the United States, and CT scanning is currently used in 90 percent of cases to confirm the presence of kidney stones. Access the abstract of the article, which was published in Annals of Emergency Medicine, the Journal of Urology and the Journal of the American College of Radiology

AHRQ Views Blog – Innovations To Foster Evidence-Based Care in Learning Health Systems: Ideas From the AHRQ Evidence-based Practice Centers

Pilot projects designed to improve health systems’ access and understanding of information in AHRQ evidence reviews are highlighted in a new blog post by Stephanie Chang, M.D., M.P.H., director of AHRQ’s Evidence-based Practice Center (EPC) Program, and Amanda Borsky, Dr.P.H., M.P.P., dissemination and implementation advisor for the EPC Program. The initiative allowed EPCs the freedom to explore different approaches to sharing evidence, including the development of dissemination, interactive data visualization and implementation products. A summary of the pilot projects is provided in an AHRQ report and a recent article in The Joint Commission Journal on Quality and Patient Safety. The journal will publish additional project findings in a series through December. 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

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

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

AHRQ in the Professional Literature

High-deductible health plan enrollment increased from 2006 to 2016, employer-funded accounts grew in largest firms. Miller GE, Vistnes JP, Rohde F, et al. Health Aff (Millwood). 2018 Aug;37(8):1231-7. Access the abstract on PubMed®.

Implementing a warm handoff between hospital and skilled nursing facility clinicians. Campbell Britton M, Hodshon B, Chaudhry SI. J Patient Saf. 2019 Sep;15(3):198-204. Access the abstract on PubMed®.

Association between practice participation in a pediatric-focused medical home learning collaborative and reduction of preventable emergency department visits by publicly-insured children in Massachusetts. Kirby PB, Christensen AL, Bannister L, et al. Pediatr Qual Saf. 2018 Aug 10;3(5):e097. eCollection 2018 Sep-Oct. Access the abstract on PubMed®.

Evaluating surgeons on intraoperative disposable supply costs: details matter. Childers CP, Hofer IS, Cheng DS, et al. J Gastrointest Surg. 2018 Aug 10. [Epub ahead of print.] Access the abstract on PubMed®.

Comparing costs of a senior wellness care redesign in group and independent physician practices of an accountable care organization. Bustamante AV, Martinez A, Rich J, et al. Int J Health Plann Manage. 2019 Jan;34(1):241-50. Epub 2018 Aug 15. Access the abstract on PubMed®.

Implementation of patient-centered prescription labeling in a safety-net ambulatory care network. Khoong EC, Cherian R, Smith DE, et al. Am J Health Syst Pharm. 2018 Aug 15;75(16):1227-38. Epub 2018 Jun 27. Access the abstract on PubMed®.

Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework. Cochon L, Lacson R, Wang A, et al. J Am Med Inform Assoc. 2018 Nov 1;25(11):1507-15. Access the abstract on PubMed®.

Design and rationale of a randomized trial: using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF). Fish-Trotter H, Collins SP, Danagoulian S, et al. Contemp Clin Trials. 2018 Sep;72:137-45. Epub 2018 Aug 17. Access the abstract on PubMed®.

Contact Information

For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@ahrq.hhs.gov.