| July 2, 2014, Issue #430 AHRQ StatsIn 2011, septicemia (bloodstream infection) was the most frequent reason for adults ages 45 to 84 to be admitted to the hospital from the emergency department. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #174: Overview of Emergency Department Visits in the United States, 2011.) Today's Headlines:AHRQ Names Former CMS Policy Expert as Deputy Director AHRQ Director Richard Kronick, Ph.D., has named Sharon Arnold, Ph.D., AHRQ's new deputy director, effective June 29. In her new position, Dr. Arnold's responsibilities include overseeing a comprehensive and coordinated scientific program supporting research, evaluations, demonstrations, training and policy analysis of health services research. Dr. Arnold came to AHRQ in April as a senior advisor on detail from the Centers for Medicare & Medicaid Services (CMS), where she had a long and distinguished history. Most recently, she served as CMS' director of the Payment Policy and Financial Management Group. In prior positions with CMS, she served as senior advisor for the Office of Legislation, director of the Demonstration and Data Analysis Group, and director of the Division of Medicare Part A Analysis. Dr. Arnold was also a senior health policy analyst with the Prospective Payment Assessment Commission, which later merged with the Physician Payment Review Commission to become the Medicare Payment Advisory Commission. She also spent 6 years at AcademyHealth, first as a senior research advisor, then as vice president, where she directed the Health Care Financing and Organization Initiative and Robert Wood Johnson Foundation-funded grant-making program. Dr. Arnold received her doctorate in public policy analysis from the Rand Graduate School in Santa Monica, California; a master's in health services research from the University of California, Los Angeles; and a bachelor's degree in biology from the University of California, San Diego. She has authored or coauthored more than 30 reports and publications on topics including health care payment and care management for chronic conditions. "I am thrilled to have Sharon join the AHRQ team," Dr. Kronick said. "Her policy and management experience will be a tremendous asset to the Agency." AHRQ Report Provides Important Reassurances About Vaccines A new report funded by AHRQ has found that serious adverse events resulting from vaccines routinely used in the United States are rare. The report, highlighted in the July issue of Pediatrics, provides the most comprehensive review to date of published studies on the safety of routine vaccines recommended for children in the United States. The report, "Safety of Vaccines Used for Routine Immunization in the United States," found scientific evidence that addresses several common concerns about a variety of vaccines. For example, the report found strong scientific evidence that there is no link between: - Measles, mumps and rubella (MMR) vaccines and autism
- Pneumonia and influenza vaccines and cardiovascular or cerebrovascular events in the elderly
- MMR, diphtheria, tetanus and pertussis; tetanus and diphtheria; Haemophilus influenza type b; and hepatitis B vaccines and childhood leukemia
In addition, the report found moderately strong scientific evidence that there is not a link between human papillomavirus (HPV) vaccines and appendicitis, stroke, seizures, venous thromboembolism, onset of juvenile arthritis or onset of type 1 diabetes. It also found that there is not a link between inactivated influenza vaccines and adverse pregnancy outcomes (such as miscarriage, low birth weight and premature birth) for women who receive the vaccine while pregnant. The AHRQ evidence review, announced July 1, was conducted by the Southern California Evidence-based Practice Center based at the RAND Corporation. New Products Bolster AHRQ Hepatitis C Resources for Clinicians and Patients Continuing education credits for a streaming video and monograph that summarize evidence about screening for hepatitis C infection are now available at no cost from AHRQ's Effective Health Care Program. The video features Roger Chou, M.D., associate professor of medicine, Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, and both resources explore how screening can impact patient outcomes and give health care providers and patients information to help make the best possible decisions. Additional AHRQ resources on hepatitis C testing include the following: New AHRQ Resources Encourage Relationships Between Health Care Providers and Their Communities To Address Obesity New toolkits on AHRQ's website offer insights for clinicians interested in developing sustainable links with community resources to help increase patient engagement in obesity management. Developing relationships between organizations that share a common goal of improving the health of people and their communities can improve patient access to preventive and chronic care services. One toolkit, "Community Connections: Linking Primary Care Patients to Local Resources for Better Management of Obesity," provides broad strategies based on actual experiences that practices can customize according to their own needs. Another resource, "Integrating Primary Care Practices and Community-Based Resources to Manage Obesity: A Bridge Building Toolkit for Rural Primary Care Practices," provides tools and concepts informed by the real world of six primary care practices in three rural Oregon communities. AHRQ's Health Care Innovations Exchange Focuses on Medicaid Initiatives To Support Medical Homes The latest issue of AHRQ's Health Care Innovations Exchange features three state programs that reimbursed medical homes for delivering high-quality, coordinated care to Medicaid beneficiaries, improving outcomes and lowering costs. One of the featured policy profiles describes the Colorado Accountable Care Collaborative, a primary care-based model in which the state Medicaid agency contracts with regional organizations that, in turn, contract with primary care-led medical homes. The medical homes coordinate specialist, hospital, behavioral health and social services on behalf of Medicaid enrollees, leading to fewer admissions and readmissions, less use of high-cost imaging services and a slowdown in the growth of emergency department visits. The payment model for the program uses a blend of fee-for-service for medical services, capitation for care management and coordination, and financial incentives to promote quality and efficiency. Collectively, these improvements have yielded an estimated $6 million in cost savings for the state. | AHRQ in the Professional Literature Srinivas SK, Fager C, Lorch SA. Variations in postdelivery infection and thrombosis by hospital teaching status. Am J Obstet Gynecol. 2013 Dec;209(6):567.e1-7. Epub 2013 Aug 3. Select to access the abstract on PubMed®. Abramson EL, Pfoh ER, Barron Y, et al. The effects of electronic prescribing by community-based providers on ambulatory medication safety. Jt Comm J Qual Patient Saf. 2013 Dec;39(12):545-52. Select to access the abstract on PubMed®. Sherman KL, Gordon EJ, Mahvi DM, et al. Surgeons' perceptions of public reporting of hospital and individual surgeon quality. Med Care. 2013 Dec;51(12):1069-75. Select to access the abstract on PubMed®. Hearld LR, Weech-Maldonado R, Asagbra OE. Variations in patient-centered medical home capacity: a linear growth curve analysis. Med Care Res Rev. 2013 Dec;70(6):597-620. Epub 2013 Aug 13. Select to access the abstract on PubMed®. Starmer AJ, Sectish TC, Simon DW, et al. Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. JAMA. 2013 Dec 4;310(21):2262-70. Select to access the abstract on PubMed®. Hellinger FJ. Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US. Pharmacoeconomics. 2013 Dec;31(12):1091-104. Select to access the abstract on PubMed®. Mariscalco MW, Flanigan DC, Mitchell J, et al. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy. 2013 Dec;29(12):1948-53. Epub 2013 Oct 17. Select to access the abstract on PubMed®. Waters TM, Chandler AM, Miom LC, et al. Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries. J Am Geriatr Soc. 2013 Dec;61(12):2186-91. Epub 2013 Nov 1. Select to access the abstract on PubMed®. Contact Information Please address comments and questions about the AHRQ Electronic Newsletter to Jeff Hardy at: (301) 427-1802 or Jeff.Hardy@ahrq.hhs.gov. |
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