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����APPStats: Federal Insurance Spending for Diet-Related Care

Among all federal health insurance providers, Medicare was the highest spender for major diet-related conditions during 2021 and 2022, with an average of $153 billion per year in expenditures. The Department of Veterans Affairs, TRICARE and other federal programs spent an average of $13 billion annually. (Source: ����APPMedical Expenditure Panel Survey Statistical Brief #561, .)

Today’s Headlines:

• Hospital Unit Lowers C. diff Infections Using ����APPSafety Program. 
• One in Seven Patients With Pancreatic Cancer Seeks Second Opinion.
• July 8 Webcast: Use Hospital Survey for CMS Safety Requirement.
• Last Informational Webinar for CLABSI Prevention Program: June 24.
• Register for Other Upcoming Webinars.
• ����APPin the Professional Literature.

Hospital Unit Lowers C. diff Infections Using ����APPSafety Program 

Using AHRQ’s Comprehensive Unit-based Safety Program (CUSP), Henry Ford Hospital in Detroit has reduced the incidence of Clostridioides difficile (C. diff) infections in its nephrology unit by 90 percent since January 2023. The hospital used the CUSP framework to engage frontline staff and significantly reduce hospital-acquired C. diff, a dangerous and highly contagious infection. Some of these interventions have now been adopted across the 800-bed hospital.

CUSP is a method that can help clinical teams make care safer by combining improved teamwork, clinical best practices and the science of patient safety. The Core CUSP toolkit gives clinical teams the training resources and tools to apply the CUSP method and build their capacity to address patient safety issues.

Patients in the 34-bed nephrology unit are vulnerable and at high risk of infection; many need dialysis multiple times each week. Those with end-stage renal disease are twice as likely to develop C. diff as other patients. Using a nurse-driven protocol to verify C. diff in patients with symptoms, the nephrology unit launched a number of interventions in early 2023 to bring down the number of C. diff infections. 

Within the first year, the hospital-onset C. diff rate dropped by about 70 percent; by the end of 2024, it was down 90 percent. Learn more in a new ����APPimpact story. All ����APPimpact stories are available for viewing here.

One in Seven Patients With Pancreatic Cancer Seeks Second Opinion

An AHRQ-funded study in Journal of the American College of Surgeons found that one in seven patients diagnosed with pancreatic ductal adenocarcinoma sought a second surgical opinion. Researchers analyzed 116,072 records of Medicare beneficiaries diagnosed with this pancreatic disease between 2013 and 2020 and found that patients who sought a second opinion were six times as likely to have surgery as those who consulted with only one surgeon. However, outcomes were generally similar for both groups. According to the authors, these findings indicate a need for further research to better understand how factors like personal motivations, referrals, disease characteristics and treatment options work alongside the number of surgical opinions to influence patients’ decisions regarding surgery for pancreatic ductal adenocarcinoma, a condition diagnosed in 64,050 Americans in 2023. Access the .

July 8 Webcast: Use Hospital Survey for CMS Safety Requirement 

On July 8, from noon to 12:45 p.m. ET, join the webcast “Understanding the Centers for Medicare & Medicaid Services (CMS) Patient Safety Structural Measure Requirements for Hospitals.” This 45-minute webcast will provide an overview of CMS’s Patient Safety Structural Measure and use of the ����APPSurveys on Patient Safety Culture® (SOPS®) Hospital Survey, and a shorter HSOPS pulse survey version, to meet requirements for Domain 3: Culture of Safety & Learning Health Systems. The presentation will include the following speakers:

• Kristina Rabarison, Dr.P.H., M.S., Social Science Analyst, CMS.
• Jonathan Bakdash, Ph.D., Social Science Analyst, AHRQ.
• Naomi Yount, Ph.D., Principal Research Associate, Westat.
• Joann Sorra, Ph.D. (Moderator), Vice President, Westat.

or visit the website to learn more about the SOPS Hospital Survey.

Last Informational Webinar for CLABSI Prevention Program: June 24

����APPis seeking intensive care units (ICUs) and non-ICUs to join a free nine-month program beginning in July to implement strategies to reduce central line-associated bloodstream infections (CLABSI). Participants will receive free expert consultation to promote infection prevention procedures, regular benchmarking reports, guidance on enhancing teamwork and continued education credits.  now for the webinar, to be held June 24, noon-12:30 p.m. ET. Recruitment is open to all states, particularly those located in the Midwest, Alaska and the Northwest. 

Register for Upcoming Webinars

• June 18, 3-4:30 p.m. ET: .
• June 24, noon-12:30 p.m. ET: .
• June 25, 1-2 p.m. ET: .
• July 8, noon-12:45 ET: .
• July 17, 12:30-2 p.m. ET: .

����APPin the Professional Literature

Person-centered preventive health care: gathering stakeholder input on evidence and implementation. Kahwati LC, Aboumatar HJ, Banger AK, et al. AJPM Focus 2025 Apr;4(2):100319. Epub 2025 Jan 31. Access the  on PubMed®.

Use of telemental health care by children and adolescents in the United States. Olfson M, McClellan C, Zuvekas SH, et al. Am J Psychiatry 2025 May;182(5):493-6. Epub 2025 Jan 15. Access the  on PubMed®.

Surveillance-associated anxiety after curative-intent cancer surgery: a systematic review. Khatri R, Quinn PL, Wells-Di Gregorio S, et al. Ann Surg Oncol 2025 Jan;32(1):47-62. Epub 2024 Sep 29. Access the  on PubMed®.

Communicating blood test results in primary care: a mixed-methods systematic review. Nankervis H, Huntley AL, Whiting P, et al. Br J Gen Pract 2025 Apr;75(753):e222-e231. Epub 2024 Mar 27. Access the  on PubMed®.

Digital supervision in the clinical learning environment: characterizing teamwork in the electronic health record. Cross DA, Weiner J, Olson APJ. J Hosp Med 2025 Apr;20(4):352-9. Epub 2024 Oct 13. Access the  on PubMed®.

Changes in primary care practice setting and practice type for Medicare beneficiaries. Bond AM, Schpero WL, Civelek Y, et al. JAMA Health Forum 2025 Apr 4;6(4):e250445. Access the  on PubMed®.

Association of limited health literacy with frailty, health-related quality of life, and health care utilization among older adults with cancer: the Cancer and Aging Resilience Evaluation Registry. Padamatinti S, Fowler ME, Stephenson C, et al. JCO Oncol Pract 2025 May;21(5):720-8. Epub 2024 Nov 8. Access the  on PubMed®.

Timing of off-label dosing of direct oral anticoagulants in three large health systems. Herron GC, DeCamillo D, Kong X, et al. Thromb Haemost 2025 Mar;125(3):278-85. Epub 2024 Jul 15. Access the  on PubMed®.