Conclusions from a new study suggest a hospital’s rating is heavily influenced by its location’s socio-economic conditions, writes Modern Healthcare. Hospitals with relatively low star ratings from the CMS were located in cities with high “stress” levels, according to the study, published in JAMA. The stress levels of cities were determined using a 2016 analysis from WalletHub, a finance website that measured socio-economic conditions like unemployment and poverty rates in 150 cities across the country.
A study published in JAMA looked at the characteristics of adverse drug events that lead to US emergency department (ED) visits. Based on 2013-2014 nationally representative surveillance data, the study found the prevalence of emergency department visits for adverse drug events in the United States was estimated to be 4 per 1000 individuals. The most common drug classes implicated were anticoagulants, antibiotics, diabetes agents, and opioid analgesics.
- US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014. JAMA. 2016;316(20):2115-2125.
The National Quality Forum’s Measure Applications Partnership (MAP) has begun its annual review of standardized performance measures that the U.S. Department of Health and Human Services (HHS) is considering for use in federal health programs. The list of approximately 100 Measures Under Consideration is open for public comment through Dec. 2, 2016. This year, in addition to recommending meaningful measures for use in Medicare programs, MAP will provide guidance on the future removal of measures. MAP’s important new role can help contribute to reducing the administrative burden of measurement while ensuring that the measures in use are high-value measures.
The New Brunswick Health Council (NBHC) has released the 2016 Report Card on the quality of health services delivered in New Brunswick. The Report Card – the sixth – also provides grades on the NBHC’s six dimensions of health service quality as well as specific grades for primary, acute and specialty health services. More detailed information on the data that is used to produce the report is available in an Excel file on the NBHC website. For the first time, the NBHC is also releasing overall grades for the province’s seven health zones which compare performance between the zones. This information will help to identify variability in health service delivery across the province and provide the health system with valuable information to prioritize improvements activities.
Read more: New Brunswick Health System Report Card 2016: https://www.nbhc.ca/health-system-report-card
Patients with multiple chronic conditions had hospital costs that were more than 19 percent higher than costs for patients with one or no chronic conditions, according to an AHRQ study. Researchers determined higher costs were driven by longer hospital stays rather than by higher costs per day. Authors used AHRQ’s 2012 Healthcare Cost and Utilization Project’s State Inpatient Databases to analyze more than 1.4 million hospital discharge records. Hospital costs for ambulatory care conditions were 19 percent higher for patients with two or three chronic conditions, 32 percent higher for those with four or five chronic conditions and 31 percent higher for those with six or more chronic conditions. The findings suggest that some of the benefit anticipated in reduced preventable hospitalizations may be offset by cost increases driven by a rise in multiple chronic conditions.
Read more: “The Effects of Multiple Chronic Conditions on Hospitalization Costs and Utilization for Ambulatory Care Sensitive Conditions in the United States: A Nationally Representative Cross-Sectional Study,”. BMC Health Services Research.
Each year, CMS publishes a list of quality and cost measures that are under consideration for Medicare quality and value-based purchasing programs, and collaborates with the National Quality Forum (NQF) to get critical input from multiple stakeholders, including patients, clinicians, commercial payers and purchasers, on the measures that are best suited for these programs. Ultimately, these measures may help patients and families choose the nursing home, hospital, or clinician that is best for them, and can help providers deliver the highest quality of care to their patients.
CMS has posted the final Measures under Consideration List on the CMS website and has sent them to NQF in preparation for this multi-stakeholder input. They can be found on the CMS website, at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Pre-Rule-Making.html and on the National Quality Forum’s (NQF) website, at http://www.qualityforum.org/Setting_Priorities/Partnership/Measure_Applications_Partnership.aspx).
This year’s MUC list contains 97 measures that have the potential to drive improvement in quality across numerous settings of care. CMS is considering new measures for nursing homes, hospitals, clinician practices, and dialysis facilities, among other settings, and continues to focus on important measures of patient outcomes, appropriate use of diagnostics and services, cost, and patient safety. This year, 39 percent of measures on the Measures under Consideration List are outcome measures, and an increased number of measures were submitted for consideration by specialty societies.
A new Consumers Report analysis finds that hospitals across the U.S. have reduced deadly, but highly preventable, central-line bloodstream infections by 50 percent since 2008. In a new investigation of nearly 2,000 hospitals, Consumer Reports looks at the five-year track record of teaching hospitals to see which have successfully reduced these infections, and which have not. The report, available in the January issue of Consumer Reports, identifies 31 U.S. teaching hospitals on its lowest-performing “zero tolerance” list and 32 on its list of top performers.
The New Hampshire Department of Health and Human Services has released the Adverse Event Reporting 2015 Report for hospitals and ambulatory surgery centers. In 2010, the state of New Hampshire enacted RSA 151-38 which adopted the National Quality Forum’s Serious
Reportable Events and added a specific event related to the transmission of blood borne pathogens. The law requires hospitals and ambulatory surgery centers to report any of these events should they occur in their facility. There are twenty-nine (29) NQF Serious Reportable Events (SREs) structured around seven categories: surgical, product or device, patient protection, care management, environmental, radiologic events and potential criminal.
Download full report: Adverse Event Reporting 2015 Report (PDF)
The Economic Alliance for Michigan (EAM) released a new report demonstrating how Center for Medicare and Medicaid Services (CMS) star ratings skew considerably lower for hospitals serving in Michigan’s impoverished areas. In July, 2016, CMS issued star ratings for hospital quality. The ratings are measured using 64 of the more than 100 CMS monitored factors. Some of these factors help determine which hospitals may receive less federal money in 2017. In September 2016, Bloomberg News BNS published a report suggesting CMS star ratings skew lower for hospitals servicing poorer areas. Findings from the EAM report suggest this phenomena was happening in Michigan. According to the report, when comparing socioeconomic factors of service areas between the average of all one-star hospitals versus the average of all five-star hospitals, the results indicate inequality. For example, the difference in household median income is $20,697 and there is a 28.3 percent difference in the level of poverty. The most staggering statistic was the difference within the percentage of people who identify themselves as African-Americans. The average of all one-star hospitals have 72.2 percent more African-American population in their immediate services areas than five-star hospitals.
- Download full report: Impacts of Socioeconomics on Hospital Quality. Focus: State of Michigan. Economics Alliance for Michigan. November 2016 (PDF)
The Healthcare Cost and Utilization Project (HCUP) announces the release of two databases:
- The 2014 National Inpatient Sample (NIS) is the largest publicly available all-payer inpatient health care database in the United States. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations.
- The 2014 Nationwide Readmissions Database (NRD) is a unique and powerful database designed to support various types of analyses of national readmission rates for all payers and the uninsured.
Read more: http://www.hcup-us.ahrq.gov/home.jsp