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AHRQ Briefs Probe Issue of Hospital Readmissions for Psychiatric Conditions

Two new briefs from AHRQ examine the issue of readmissions for psychiatric hospitalization. A statistical brief from AHRQ's Healthcare Cost and Utilization Project found that 30-day readmission rates in 2012 were 15.7% when the primary diagnosis was schizophrenia and 9% when the primary diagnosis involved mood disorders. This compares with a 30-day readmission rate of 3.8% for all other nonmental health/substance abuse conditions. Meanwhile, a technical brief from AHRQ's Effective Health Care Program found that the availability and implementation of strategies to reduce hospital readmissions for psychiatric conditions vary widely and that these readmissions are probably undercounted. It concluded that more research is needed to determine which strategies work best to reduce readmissions for psychiatric conditions, ways to accurately measure the most meaningful outcomes, and the best ways to apply effective strategies in settings with varying resources. In 2012, nearly one quarter of U.S. adults experienced some form of mental or substance use disorder.

  
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Measuring Patient-Reported Outcomes Can Help Identify Patients at Higher Risk for Hospital Readmission, AHRQ Study Finds

Despite widespread efforts to accurately predict which patients are at greatest risk for being readmitted to the hospital within 30 days of discharge, patient-reported outcome measures are infrequently used in predictive models. To find out whether patients' self-reported views of their health services can accurately predict readmission, a research team at Cook County Health and Hospital System in Chicago administered the Memorial Symptom Assessment Scale and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health short form to 196 patients at discharge. Patients also took the health assessment surveys at 30, 90, and 180 days after discharge. Patients who scored poorly on the PROMIS measures of general self-rated health and mental health were at greater risk of rehospitalization within 14 days of discharge, researchers found. However, low scores by patients on the Memorial Symptom Assessment Scale and the PROMIS measures of global physical health were better able to predict readmission. Because the sample size of the population was relatively small, researchers acknowledged that the findings may be limited. They recommended that systems to obtain patient-reported outcomes be developed as a routine part of clinical care. The study, "When Do Patient-Reported Outcome Measures Inform Readmission Risk?" and abstract were published online in Journal of Hospital Medicine.

  
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The nation's uninsurance rate has dropped significantly since the Affordable Care Act was enacted. But millions of Americans remain uninsured.

In order to get a full picture of the lives of the uninsured and explore their feelings around enrolling in health insurance, the Robert Wood Johnson Foundation commissioned a national survey with uninsured adults at the conclusion of the second open enrollment period for the health insurance marketplace.

  
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The Issue: Most uninsured individuals value health insurance and many have been actively trying to get it on their own. However, they feel it is out of reach financially right now.

 

Most of the uninsured population values health insurance but many see cost as a barrier. Research findings point to the need for education around the tax credit and the increasing penalty for not having insurance. This report presents the findings from a national survey of 1,270 uninsured adults, ages 18 to 64, fielded May 5 through May 17, 2015. The margin of error is +/- 3.4 percentage points.

 

Key Findings

 

* Of uninsured individuals, 43% say they have looked to get health insurance on their own in the last 12 months and a similar number (41%) report they went to the marketplace to find a health plan.

 

* Almost 8 in 10 (79%) of the uninsured who looked for insurance say that after weighing everything, they could not afford a plan.

 

* More than half of all uninsured (56%) say they are likely to go to the marketplace to find a health plan in the future. But there are knowledge gaps.

 

* Six in 10 are confused about or have not heard of the tax credit, and more than 7 in 10 want one-on-one help understanding their insurance options.

 

* After learning about the increasing penalty amounts for 2015 and 2016, 26% say this information makes them more likely to get insurance. Of note, only 6% say the increasing fine would make them less likely to get insurance.

 

 

October is National Physical Therapy Month

Happy National Physical Therapy Month to all our PT colleagues! National Physical Therapy Month (NPTM) is a commemoration held each October by the American Physical Therapy Association. NPTM is designed to recognize the impact that physical therapists and physical therapist assistants make in restoring and improving motion in people's lives. Physical Therapists have a profound effect on home care patient outcomes. Remember:

  
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* Physical therapists significantly improve mobility to perform daily activities.

 

* Physical therapists provide an alternative to painful and expensive surgery, in many cases.

 

* Physical therapists manage or eliminate pain without long-term use of prescription medications and its side effects, in many cases.