| November 10, 2020, Issue #738  Access more data on this topic in the associated statistical brief.  Veterans received better care than nonveterans in areas such as vaccinations and health screenings between 2015 and 2018, according to a new chartbook from AHRQ. However, veterans received worse care than nonveterans when it came to access to care and prescription medications. The new analysis provides contextual health data on veterans and nonveterans, such as comparisons on smoking rates, experience with chronic pain and prevalence of health conditions. Its findings on access to care, quality of care and mortality rates were based on 65 quality measures. Among comparisons with nonveterans, it indicated that veterans: - Had higher rates of vaccinations for flu, shingles, pneumonia and tetanus
- Had higher rates of screening for blood pressure, cholesterol and glucose
- Had more difficulty contacting their usual source of care by phone during regular business hours
- Were more likely to receive an inappropriate medication for older adults
Comparisons among different groups of veterans and Veterans Healthcare Administration (VHA) enrollees identified disparities related to age, sex and disability status. Some racial/ethnic disparities were also found but tended to be smaller than disparities observed among nonveterans. The chartbook is a collaboration between AHRQ, the Department of Veterans Affairs Office of Health Equity, and the National Healthcare Quality and Disparities Inter-Agency Workgroup. Access the chartbook. |  Healthcare costs for seniors who needed emergency services after a fall averaged $26,143 in the year following the event, according to an AHRQ-funded study published in The Journal of the American Geriatrics Society. Those costs significantly exceeded the average $8,642 in healthcare costs in the year prior to the event. Researchers reviewed Medicare expenditures of 2,494 patients for a year after they were transported to one of 51 emergency departments for a fall. The average $26,143 in costs after falls included $1,957 spent on acute care and $20,560 spent on post-acute care. Higher baseline costs, older age, comorbidities, arm and leg fractures, noninjury diagnoses and surgical interventions were all associated with higher costs. Access the abstract. | A method of protecting central venous catheters from bacterial contamination has not been found to significantly help avoid central line-associated bloodstream infections (CLABSIs) in children. In an AHRQ-funded study published in Infection Control & Hospital Epidemiology, researchers tested the use of caps impregnated with a 70 percent isopropyl alcohol solution among pediatric hematology/oncology patients. This study was performed in patients' homes, in part because pediatric cancer patients are often treated in home and office settings rather than in the hospital, and care provided in homes may not follow infection prevention best practices. However, in a 2-year randomized controlled trial, researchers found a small but not statistically significant reduction in CLABSI in clinics providing the caps compared with those providing standard care. There was a reduction in positive blood culture incidence that was barely statistically significant. Access the abstract. 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). | AHRQ in the Professional Literature Use of the ICD-10 vision codes to study ocular conditions in Medicare beneficiaries with stroke. Hreha KP, Fisher SR, Reistetter TA, et al. BMC Health Serv Res. 2020 Jul 8;20(1):628. Access the abstract on PubMed®. Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals. Hsu HE, Wang R, Broadwell C, et al. JAMA Netw Open. 2020 Jul;3(7):e209700. Access the abstract on PubMed®. Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016. Jeffery MM, Hooten WM, Jena AB, et al. JAMA Netw Open. 2019 Aug 2;2(8):e198325. Access the abstract on PubMed®. Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia. Ji W, McKenna C, Ochoa A, et al. JAMA Netw Open. 2019 Oct 2;2(10):e1913674. Access the abstract on PubMed®. Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial. Mahorter SS, Knerr S, Bowles EJA, et al. Cancer. 2020 Apr 15;126(8):1614-21. Epub 2020 Jan 24. Access the abstract on PubMed®. Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition. Fashaw S, Chisholm L, Mor V, et al. J Am Geriatr Soc. 2020 Mar;68(3):630-6. Epub 2020 Jan 22. Access the abstract on PubMed®. Out-of-network bills for privately insured patients undergoing elective surgery with in-network primary surgeons and facilities. Chhabra KR, Sheetz KH, Nuliyalu U, et al. JAMA. 2020 Feb 11;323(6):538-47. Access the abstract on PubMed®. Parental considerations regarding cure and late effects for children with cancer. Greenzang KA, Al-Sayegh H, Ma C, et al. Pediatrics. 2020 May;145(5):e20193552. Epub 2020 Apr 13. 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. |
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