Tag Archives: ahrq

Drugs send more of the 45-plus crowd to hospitals

At a time when overall prescription drug use is climbing across the board, the AHRQ reports that the number of medication- and drug-related hospital visits for Americans over the age of 45 doubled between 1997 and 2008. Abuse is also on the rise in that age group, and the cost burden for the increase has fallen heavily upon Medicare and Medicaid. The numbers come from the AHRQ’s Healthcare Cost and Utilization Project, a wonderfully deep well of cost-related statistics from 2008.

A few numbers from the release:

Hospital admissions among those 45 years and older were driven by growth in discharges for three types of medication and drug-related conditions – drug-induced delirium; “poisoning” or overdose by codeine, meperidine and other opiate-based pain medicines; and withdrawal from narcotic or non-narcotic drugs.

Admissions for all medication and drug-related conditions grew by 117 percent – from 30,100 to 65,400 – for 45- to 64-year-olds between 1997 and 2008. The rate of admissions for people ages 65 to 84 closely followed, growing by 96 percent, and for people ages 85 and older, the rate grew by 87 percent. By comparison, the number of hospital admissions for these conditions among adults ages 18 to 44 declined slightly by 11 percent.

Beyond the headline-making news involving drugs, AHRQ’s report includes data on other types of medical conditions treated in hospitals, surgical procedures and costs in 2008.

Forum offers stats on well-being of elderly

AgingStats.gov is an often-overlooked federal clearinghouse of aging-related data from the Federal Interagency Forum on Age-Related Statistics. It focuses on summary reports.

Its latest effort, Older Americans 2010: Key Indicators of Well-Being (174-page PDF), summarizes 37 key indicators it believes are broadly relevant and easy to understand. By my count, 24 of those are explicitly health-related.

Everything is illustrated with an abundance of charts and maps, and an emphasis on bulleted summary and analysis helps keep things accessible. Those looking for a deeper dive into the summary numbers will want to head to the appendix.

As part of its health sections, the report contains seven “Health Status” indicators, including chronic health conditions, depressive symptoms, sensory impairments and oral health, and functional limitations.

One example:

life

It also includes eight “Health Risks and Behaviors” – things like diet, air quality, mammography and vaccinations – and nine “Health Care” indicators, including expenditures, prescription drugs and residential services.

The forum, which nobody seems to refer to by the acronym FIFARS, has been around since 1986. Participants include the Census Bureau, a number of Health and Human Services departments (AHRQ, CMS, NCHS and others), HUD, the Bureau of Labor Statistics, the Department of Veterans Affairs, the EPA, the Office of Management and Budget, and the Social Security Administration.

Thanks to AHCJ member Eileen Beal for suggesting this as a tool other members might find helpful.

AHRQ releases ’09 state data on health care quality

newmexicoThe AHRQ has released the 2009 version of its state snapshots, which are particularly accessible versions of the National Healthcare Quality Report.

The state-by-state information includes, for the first time, data on health insurance, including data on health care quality categorized by source of payment, including private insurance, Medicare, Medicaid and those without insurance.

The snapshots also compare relative health care quality of each state, both overall and in specific areas such as preventive care and ambulatory care.

My favorite part is the 3.5 mb Excel file that has each state’s numbers for everything the snapshots measure. It allows relatively easy comparisons that go far beyond the simple health-o-meter snapshots themselves.

Related

AHRQ asks ‘Who’s paying for rising health costs?’

The latest statistics brief out of the Agency for Healthcare Research and Quality address what researchers called the “growing burden of hospital-based medical care expenses on the government, tax payers, consumers, and employers.” In this brief, they’re looking to figure out where to put the blame for those in-patient cost jumps that occurred between 2001 and 2007 and thus divided the increases into four categories: Medicare, Medicaid, private insurance and payments from those without insurance.

payers2

The numbers hold a few interesting subplots, any one of which would benefit from further exploration. Here are a few:

  • When you compare 2001 and 2007, private insurance paid for slightly fewer stays, while stays for Medicare and Medicaid were up,respectively, by 20.1 and 29.9 percent.
  • “From 2001 to 2007, the number of stays with a principal diagnosis of blood infection nearly doubled (97.1 percent; 675,400 stays in 2007).”
  • The cost of a hospitalization for intestinal infection jumped 148 percent, yet hospital stays for such infections were up only 69.5 percent.
  • “For four of the top ten conditions—blood infection, acute kidney failure, respiratory insufficiency, arrest, or failure, and skin and subcutaneous skin infections—the uninsured demonstrated greater increases in growth in total costs and number of hospital stays than the other three payer groups.”
  • Private insurance paid 55.7 more for C-section-related hospital stays over the study period, while Medicaid costs increased 95.1 percent for the same sort of visits.

Check pages seven through 10 for summary tables, including overall numbers and two tables of the ten conditions for which costs are increasing most rapidly.

increases

Report: Health care disparities aren’t getting better

In their coverage of AHRQ’s latest annual quality and disparities reports (Quality PDF | Disparities PDF), most outlets focused on disheartening news on health-care-associated infections, but the disparities report also deserves a second look. It’s 302 pages that can be oversimplified as “disparities still exist, they’re not getting better, and they’re worse in some areas than in others.”disparities

Here are a few of the more interesting bullet points, all pulled from the first 16 pages of summary information.

  • For Blacks, Asians, and Hispanics, at least two-thirds of measures of quality of care are not improving (gap either stayed the same or increased).
  • For Blacks, only about 20% of measures of disparities in quality of care improved (gap decreased).
  • For poor people, disparities are improving for almost half of the quality measures.
  • The largest disparities for Blacks, AI/ANs, and Hispanics included the rate of new AIDS cases. The rate for Blacks was almost 10 times as high as the rate for Whites, for Hispanics more than 3 times as high, and for AI/ANs 1.4 times as high.
  • Asians were 1.5 times as likely as Whites to report they sometimes or never get care for illness or injury as soon as wanted. Poor people were more than twice as likely as high-income people to report this
    problem.
  • Hispanics were 1.7 times as likely as Whites and poor people were 3 times as likely as high-income people to report poor provider-patient communication.
  • Blacks, Asians, AI/ANs, and Hispanics all experienced disparities in the percentage of adults age 50 and
    over who received a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test and in
    commended hospital care for pneumonia.
  • Blacks and Hispanics both had worsening disparities in colorectal cancer mortality from 2000 to 2006.

The report doesn’t stop with bullet points, of course. Anyone who takes a few minutes to page through the other 280-some-odd pages will be rewarded with in-depth information on disparities in a number of specific diseases and issues – including breast cancer, diabetes, HIV, palliative care, mental health and access to health care – all buttressed with charts, graphs, explanations and data.