Well-Child Visits on the Rise, But Disturbing Gaps Remain for Underserved Populations

AHRQ Stats: Largest Source of Mental Disorder Spending

In 2019, 41.5 percent of medical spending for mental disorders occurred during office-based and outpatient visits, representing the largest expenditure source. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #539, Healthcare Expenditures for Treatment of Mental Disorders: Estimates for Adults Ages 18 and Older, U.S. Civilian Noninstitutionalized Population, 2019.)

Today's Headlines:

• Well-Child Visits on the Rise, But Disturbing Gaps Remain for Underserved Populations.
• AHRQ Views Blog: AHRQ Expands Its Repertoire To Eliminate Diagnostic Errors.
• Prescribing Clinicians Often Ignore Drug Interaction Alerts.
• New Federal Reports on Long COVID Support Patients and Further Research.
• Highlights From AHRQ’s Patient Safety Network.
• Job Opportunities at AHRQ.
• AHRQ in the Professional Literature.

Well-Child Visits on the Rise, But Disturbing Gaps Remain for Underserved Populations

The rate of children receiving the recommended number of well-child visits has increased, but large gaps remain across race/ethnicity, poverty level, insurance and geography, a new AHRQ data analysis has found. In a research letter, published in JAMA Pediatrics, AHRQ researchers used Medical Expenditure Panel Survey data to gauge well-child visit adherence by comparing children’s well-child visits during the calendar year with the number recommended by the American Academy of Pediatrics’ Bright Futures guidelines. Adherence rose from 47.9 percent in 2006 and 2007 to 62.3 percent in 2016 and 2017. But among uninsured children in 2016 and 2017, adherence was only half the national average, and more than 20 percentage points separated the highest- and lowest-adherence geographic regions of the nation. The disparity between White non-Hispanic and Black non-Hispanic children widened during the period. Access the abstract.

AHRQ Views Blog: AHRQ Expands Its Repertoire To Eliminate Diagnostic Errors

In a new blog post, AHRQ Director Robert Otto Valdez, Ph.D. M.H.S.A, describes the agency’s growing commitment to diagnostic excellence and introduces Measure Dx, a new evidence-based tool that helps users identify diagnostic safety events and gain insights for improvement. One in 20 adults annually experiences a diagnostic error in outpatient settings. An estimated 250,000 diagnostic errors occur annually in U.S. hospitals. The Measure Dx tool exemplifies AHRQ’s commitment to promoting diagnostic excellence, including recent activities aimed at growing the research field, supporting clinical teams and promoting standardized data collection. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

Prescribing Clinicians Often Ignore Drug Interaction Alerts

Prescribers ignore or override more than 50 percent of drug-drug interaction alerts generated by clinical decision support systems, according to AHRQ-funded research published in Studies in Health Technology and Informatics. Drug-drug interactions are responsible for up to 14 percent of adverse drug reactions in hospitalized patients and occur in up to 13 percent of elderly ambulatory patients. The authors reviewed 34 studies on the rate of drug-drug interaction alert overrides and medications involved in the overrides. They found that the override rate ranged from 55 to 98 percent, with more than half of the studies identifying the most common medications involved in the acceptance or overriding of alerts. The authors suggest that the high prevalence of alert overrides highlights the need for decision support systems that take user, drug and institutional factors into consideration, as well as metrics that make it easier to measure the harm associated with overrides. Access the study abstract and a description of the research project.

New Federal Reports on Long COVID Support Patients and Further Research

A pair of reports developed in response to President Joe Biden’s Memorandum on Addressing the Long-Term Effects of COVID-19 are now available to help Americans affected by long COVID:

• The National Research Action Plan on Long COVID (PDF, 1.3 MB) details advances in current research and charts a course for future study to better understand prevention and treatment of long COVID based on four guiding principles: health equity, accelerating and expanding current research, orienting the research effort to prove patient care, and partner engagement.
• The Services and Supports for Longer-Term Impacts of COVID-19 report highlights resources for healthcare workers and those affected by the broader effects of COVID-19, including not only long COVID but also effects on mental health and substance use, and loss of caregivers and loved ones.

People with long COVID have disease symptoms that persist for weeks or months after acute COVID-19 infection. It remains difficult to measure precisely, but an estimated 7.7 to 23 million Americans have developed long COVID, and roughly one million people may be out of the workforce at any given time due to the condition.

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:

• Quality measures for patients at risk of adverse outcomes in the Veterans Health Administration: expert panel recommendations.
• Defining and studying errors in surgical care: a systematic review.
• Health care quality and safety in a correctional system: creating goals and performance measures for improvement.

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).

Job Opportunities at AHRQ

Join the team that strives to improve healthcare for all Americans by investing in health systems research, creating tools and strategies for practice improvement, and providing data and analytics to help decision makers understand the healthcare system and identify opportunities for improvement. Current vacancies include:

• Ethics Specialist, Office of Management Services. Application deadline: Aug. 31.
• Health Scientist Administrator, Office of Extramural Research, Education, and Priority Populations. Application deadline: Sept. 6.
• Physician, Center for Evidence and Practice Improvement. Application deadline: Sept. 16.
• Health Scientist Administrator, Office of Extramural Research, and Priority Populations. Application deadline: Sept. 16.

AHRQ in the Professional Literature

A disproportionality analysis of drug-drug interactions of tizanidine and CYP1A2 inhibitors from the FDA Adverse Event Reporting System (FAERS). Villa-Zapata L, Gómez-Lumbreras A, Horn J, et al. Drug Saf 2022 Aug;45(8):863-71. Epub 2022 Jul 14. Access the abstract on PubMed®.

Patients' lived experiences and recommendations for enhanced awareness and use of integrative oncology services in cancer care. Womack DM, Kennedy R, Chamberlin SR, et al. Patient Educ Couns 2022 Jul;105(7):2557-61. Epub 2021 Nov 25. Access the abstract on PubMed®.

Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities. Thorsness R, Wang V, Patzer RE, et al. JAMA 2021 Dec 14;326(22):2323-5. Access the abstract on PubMed®.

Aligning to improve pediatric health care quality. Olin SS, Freed GL, Scholle SH, et al. Acad Pediatr 2022 Apr;22(3s):S115-8. Epub 2021 Sep 5. Access the abstract on PubMed®.

Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol. Lin E, Uhler LM, Finley EP, et al. BMJ Open 2022 Feb 21;12(2):e055933. Access the abstract on PubMed®.

Decreased access to pediatric liver transplantation during the COVID-19 pandemic. Kemme S, Yoeli D, Sundaram SS, et al. Pediatr Transplant 2022 Mar;26(2):e14162. Epub 2021 Oct 11. Access the abstract on PubMed®.

Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019. Ferucci ED, Arnold RI, Holck P. Telemed J E Health 2022 May;28(5):682-9. Epub 2021 Sep 9. Access the abstract on PubMed®.

Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis. Liu MA, Keeney T, Papaila A, et al. JCO Oncol Pract 2022 Jun;18(6):e886-95. Epub 2022 Feb 7. Access the abstract on PubMed®.