| March 2, 2021, Issue #753 In 2017, one million hospital stays with a principal diagnosis of cancer cost a total of $23 billion. More than one-third of that cost was for three types of cancer: colorectal cancer, respiratory cancer and secondary malignancies. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #270, Cancer-Related Hospitalizations for Adults, 2017.)  AHRQ's role in helping more than 8,500 nursing homes keep residents and staff safe from COVID-19 is the subject of a new AHRQ Views blog by Acting Director David Meyers, M.D., and Mamatha Pancholi, M.S., the agency's chief data officer. The AHRQ ECHO National Nursing Home COVID-19 Action Network is a partnership among AHRQ, the Institute for Healthcare Improvement and the University of New Mexico's Project ECHO to provide free training and mentorship to help nursing homes increase the use of evidence-based infection prevention and safety practices. The effort, built around nearly 100 training centers, is paying special attention to the needs of facilities that care for medically underserved communities. Access the blog post. To receive all blog posts, submit your email address and select "AHRQ Views Blog." | A new study published in JAMA Network Open found that hospitals using AHRQ's Safety Program for Improving Antibiotic Use decreased their use of antibiotic medications and reduced C. difficile infections. The safety program applies methods from the agency's signature Comprehensive Unit-based Safety Program and the newly developed Four Moments of Antibiotic Decision Making. The study of 402 hospitals showed improvements in four key components of antibiotic stewardship programs: prior approval, review and feedback of antibiotic prescriptions; availability of local antibiotic guidelines; having at least one paid, dedicated staffer leading the antibiotic stewardship program; and quarterly reporting of antibiotic use. Total antibiotic use in the study was reduced by an average of 30.3 days of antibiotic therapy per 1,000 patient days. The program also demonstrated a 19.5 percent reduction in C. difficile infections over the one-year period. Access the study abstract and the press release.  Physicians continue to join health systems almost everywhere in the United States, a study of AHRQ data has found. The analysis of the AHRQ Compendium of U.S. Health Systems, published in Health Affairs, found that the trend of doctors joining health systems increased in 92 percent of metropolitan statistical areas (MSAs) from 2016 to 2018; by 2018, 113 of the nation's 382 MSAs had more than half of their physicians in health systems. The phenomenon was especially prevalent in the Midwest and Northeast, researchers found. The authors noted previously published research that found that consolidation tends to lead to higher prices without strong evidence of quality improvement and called for more research to monitor competition at the market level. 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 has updated its Compendium of U.S. Health Systems with new information about the structural characteristics and attributes of the nation's 637 health systems. The updated compendium includes new data from 2018 on system ownership of nursing homes and insurance products as well as system participation in alternative payment models such as Accountable Care Organizations. In addition, healthcare workforce information now includes counts of nurse practitioners and physician assistants in individual systems. The compendium was developed by AHRQ's Comparative Health System Performance Initiative, which studies how healthcare delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Voluntary data submission schedules have been announced for the AHRQ's Surveys on Patient Safety Culture™ (SOPS®) Databases: The SOPS program is designed to help healthcare organizations assess how providers and staff members perceive various aspects of patient safety culture. Participating facilities will receive feedback reports displaying their results as well as aggregated results from all database participants. For technical assistance on data submission, call 1-888-324-9790. | AHRQ in the Professional Literature Strategy for reliable identification of ischaemic stroke, thrombolytics and thrombectomy in large administrative databases. Zachrison KS, Li S, Reeves MJ, et al. Stroke Vasc Neurol. 2020 Nov 11. [Epub ahead of print.] Access the abstract on PubMed®. Severe housing insecurity during pregnancy: association with adverse birth and infant outcomes. Leifheit KM, Schwartz GL, Pollack CE, et al. Int J Environ Res Public Health. 2020 Nov 21;17(22):8659. Access the abstract on PubMed®. Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system. Yeung K, Richards J, Goemer E, et al. Health Serv Res. 2020 Dec;55(6):913-23. Access the abstract on PubMed®. Health and economic outcomes of newborn screening for infantile-onset Pompe disease. Richardson JS, Kemper AR, Grosse SD, et al. Genet Med. 2020 Dec 7. [Epub ahead of print.] Access the abstract on PubMed®. Omissions of care in nursing homes: a uniform definition for research and quality improvement. Mangrum R, Stewart MD, Gifford DR, et al. J Am Med Dir Assoc. 2020 Nov;21(11):1587-91.e2. Epub 2020 Sep 28. Access the abstract on PubMed®. Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management. Makelarski JA, DePumpo M, Boyd K, et al. J Healthc Qual. 2020 Sep/Oct;42(5):278-86. Access the abstract on PubMed®. The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts. Myong C, Hull P, Price M, et al. PLoS One. 2020 Dec 3;15(12):e0243279. Access the abstract on PubMed®. Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics. Kranz AM, Ryan J, Mahmud A, et al. Prev Chronic Dis. 2020 Oct 29;17:E134. 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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