COVID-19 Surges Tied to Higher Risks for All Hospital Patients, AHRQ Study Finds

Editor’s Note: Due to the Christmas and New Year’s holidays, AHRQ News Now will not publish again until Jan. 7.

AHRQ Stats: Disparities in Severe Maternal Morbidity

Black non-Hispanic women and Hispanic women both experienced a 43 percent increase in severe maternal morbidity between 2016 and 2021, compared with a 34 percent increase among White non-Hispanic women. In that same timeframe, women of other non-Hispanic race and ethnicity experienced a 48 percent increase in severe maternal morbidity—the greatest increase among any ethnicity. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #312, Trends in Severe Maternal Morbidity Complications by Patient Characteristics, 2016-2021 [PDF, 943 KB].)

Today's Headlines:

• COVID-19 Surges Tied to Higher Risks for All Hospital Patients, AHRQ Study Finds.
• Study Highlights Effective Strategy for Tackling Unhealthy Alcohol Use in Primary Care.
• AHRQ Announces Interest in Funding Research on Diagnosis and Treatment of Menopause.
• Machine Learning Outperforms Questionnaires in Identifying Social Needs, but Bias Remains.
• Employer-Employee Data Highlight Reasons Some Small Businesses Offer Health Insurance, Others Don’t.
• New Program Offers Help Implementing AHRQ Resources for Diagnostic Excellence.
• Register for Upcoming AHRQ Webinars.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

COVID-19 Surges Tied to Higher Risks for All Hospital Patients, AHRQ Study Finds

Hospitals with high COVID-19 patient loads faced increased adverse events for all patients, an AHRQ study showed. Adverse event rates rose from 59 per 1,000 admissions in low-burden weeks to 97 per 1,000 in high-burden weeks, researchers found using Medicare data from AHRQ’s Quality and Safety Review System. This pattern held true for both COVID-19 and non-COVID-19 patients, indicating that hospital stress from surges impacted overall patient safety. The authors said their findings highlight a need for hospitals to build resilience and surge capacity to maintain safety during future demand spikes. Access the study, which was published in JAMA Network Open.

Study Highlights Effective Strategy for Tackling Unhealthy Alcohol Use in Primary Care

An AHRQ-funded study reported that practice facilitation significantly improved how primary care practices addressed unhealthy alcohol use, a leading preventable cause of death. Researchers found that over 6 months, screening rates in the intervention group surged from 2.1 percent to 35.5 percent, and brief interventions increased from 26.2 percent to 62.6 percent, while the control group showed less improvement. Clinicians also gained confidence in implementing unhealthy alcohol use care, a key barrier before the study. Conducted as part of AHRQ’s EvidenceNOW: Managing Unhealthy Alcohol Use initiative, the randomized clinical trial involved 76 primary care practices and compared the impact of tailored support and training with usual care. Researchers concluded their findings underscored the potential of practice facilitation to transform preventive care, helping tens of thousands more patients access essential unhealthy alcohol use services annually. Access the abstract.

AHRQ Announces Interest in Funding Research on Diagnosis and Treatment of Menopause

A new Special Emphasis Notice from AHRQ signals the agency’s interest in receiving grant applications for health services research on improving the diagnosis, treatment and management of perimenopause and menopausal symptoms. While safe and effective nonpharmacological and pharmacologic interventions are available to address menopausal symptoms, many are underutilized. Treatments are also inequitably available, leading to disparities in menopause-related health outcomes and access to treatments. AHRQ seeks research proposals aimed at developing, implementing, evaluating and scaling person-centered models of care to optimize women’s health during midlife and the menopausal transition. 

Machine Learning Outperforms Questionnaires in Identifying Social Needs, but Bias Remains

An AHRQ-funded study found that machine-learning predictive models using electronic health records (EHRs) significantly outperformed traditional screening questionnaires in identifying patients with social needs such as housing instability, food insecurity and financial strain. In the study, published in PLOS One, researchers found that models built from EHR data were more accurate, with better sensitivity and specificity, compared with those based solely on patient responses to questionnaires. However, researchers found biases in all models, with performance varying across racial and ethnic groups. Including demographic factors like age and gender improved some models’ accuracy but did not fully address disparities. Researchers concluded that their findings highlight the potential of machine learning to enhance healthcare equity, but they called for refinement to ensure these tools serve all populations effectively. Access the abstract.

Employer-Employee Data Highlight Reasons Some Small Businesses Offer Health Insurance, Others Don’t

Small firms are more likely to provide health insurance when their employees earn higher incomes, according to a study by AHRQ researchers that sheds light on the factors that influence small business health insurance decisions. This study was the first application of the new Medical Expenditure Panel Survey–Insurance Component with Administrative Records, a unique dataset combining employer survey data and government records. In addition, researchers found that workers in establishments with mostly married workers or employees with larger families are more inclined to receive an offer of dependent coverage. These findings suggested that employee demographics play a big role in shaping benefits. Researchers anticipated this work can help inform how workforce characteristics affect access to health insurance and can guide policies to make coverage more widely available for small-business employees. Access the abstract.

New Program Offers Help Implementing AHRQ Resources for Diagnostic Excellence

A new diagnostic safety improvement program is recruiting healthcare organizations to use and evaluate AHRQ resources including Calibrate Dx, Measure Dx and the Toolkit for Engaging Patients in Diagnostic Safety. Organizations that participate in AHRQ’s Implementing Diagnostic Excellence Across Systems (IDEAS) project will receive support and training to implement sustainable improvement. Continuing education credits and American Board of Medical Specialties Maintenance of Certification points will be available. Learn more, including how to participate in the project and register for a Jan. 16 webinar. Send questions to IDEASproject@rand.org.

Register for Upcoming AHRQ Webinars

• Jan. 15, 1 to 2 p.m. ET: AHRQ’s Surveys on Patient Safety Culture® (SOPS) Program: An Overview for New Users will describe the SOPS surveys, supplemental items, rules for administration, public databases, resources available and the relationship of SOPS surveys to patient safety outcomes.
• Jan. 16, 2 to 3:15 p.m. ET: Approaches to Address Health Risks in Older Adults, sponsored by AHRQ’s National Center for Excellence in Primary Care Research, will explore the role of primary care in optimizing health and well-being for older adults. 
• Jan. 21, noon to 1 p.m. ET: Engineering Safety into Practice through Implementation of the 2025 SAFER Guides, will highlight recently updated guides designed to help healthcare organizations conduct proactive self-assessments to evaluate the safety and effectiveness of electronic health record implementations. The webinar on engineering safety is sponsored by the AHRQ-led National Action Alliance for Patient and Workforce Safety. 

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:

• Comparing safety, performance and user perceptions of a patient-specific indication-based prescribing tool with current practice: a mixed methods randomised user testing study.
• Enhancing safe medication use in home care: insights from informal caregivers.
• Perspectives on anesthesia and perioperative patient safety: past, present, and future.

Review additional new publications in PSNet’s current issue, including recent cases and commentaries and AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

AHRQ in the Professional Literature

Implementation of electronic triggers to identify diagnostic errors in emergency departments. Vaghani V, Gupta A, Mir U, et al. JAMA Intern Med 2024 Dec 2. [Epub ahead of print.] Access the abstract on PubMed®.

The high costs of anticancer therapies in the USA: challenges, opportunities and progress. Jazowski SA, Nayak RK, Dusetzina SB. Nat Rev Clin Oncol 2024 Dec;21(12):888-99. Epub 2024 Oct 4. Access the abstract on PubMed®.

A pragmatic approach to identifying and profiling primary care clinicians and primary care practices in the USA. Zhan C, McNellis RJ, O'Malley PG, et al. J Gen Intern Med 2024 Aug;39(11):1962-8. Epub 2024 Jan 25. Access the abstract on PubMed®.

You cannot function in "overwhelm": helping primary care navigate the slow end of the pandemic. Sullivan EE, Etz RS, Gonzalez MM, et al. J Healthc Manag 2024 May-Jun;69(3):190-204. Epub 2024 May 10. Access the abstract on PubMed®.

Health care utilization with telemedicine and in-person visits in pediatric primary care. Casey SD, Huang J, Parry DD, et al. JAMA Health Forum 2024 Nov;5(11):e244156. Access the abstract on PubMed®.

Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics. Davis MM, Coury J, Sanchez V, et al. BMC Health Serv Res 2024 Nov 12;24(1):1384. Access the abstract on PubMed®.

Enrollment of underserved racial and ethnic populations in pediatric asthma clinical trials. Geanacopoulos AT, Wu AC, Bourgeois FT, et al. J Allergy Clin Immunol Glob 2024 Nov;3(4):100315. Epub 2024 Jul 26. Access the abstract on PubMed®.

Characteristics of patients hospitalized in rural and urban ICUs from 2010 to 2019. Harlan EA, Ghous M, Moscovice IS, et al. Crit Care Med 2024 Oct;52(10):1577-86. Epub 2024 Jun 26. Access the abstract on PubMed®.