National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Behavioral Health (3)
- Cancer (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (6)
- Comparative Effectiveness (4)
- Data (3)
- Dental and Oral Health (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (3)
- Elderly (2)
- Emergency Department (9)
- Emergency Medical Services (EMS) (3)
- Healthcare-Associated Infections (HAIs) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (47)
- Healthcare Costs (3)
- Healthcare Delivery (1)
- Healthcare Utilization (4)
- Health Insurance (1)
- Heart Disease and Health (2)
- Hospital Discharge (1)
- Hospitalization (17)
- Hospital Readmissions (2)
- Hospitals (3)
- Human Immunodeficiency Virus (HIV) (2)
- Infectious Diseases (1)
- Influenza (1)
- Inpatient Care (2)
- Labor and Delivery (1)
- Medicaid (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (3)
- Mortality (3)
- Newborns/Infants (3)
- Opioids (1)
- Orthopedics (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (4)
- Patient Safety (6)
- Pneumonia (1)
- Policy (2)
- Practice Patterns (1)
- Pregnancy (2)
- Pressure Ulcers (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (5)
- Respiratory Conditions (4)
- Risk (3)
- Stroke (1)
- Substance Abuse (1)
- Surgery (8)
- Transitions of Care (1)
- Transplantation (1)
- Trauma (2)
- Uninsured (1)
- Vaccination (1)
- Vulnerable Populations (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 47 Research Studies DisplayedHellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Mukamel DB, Ladd H, Li Y
AHRQ Author: Ngo-Metzger Q
Have racial disparities in ambulatory care sensitive admissions abated over time?
The researchers evaluated whether disparities in quality of ambulatory care have abated during the decade of 2000 by asking whether there were there differences in ambulatory care sensitive hospital admissions rates by race? In 2003 the overall Prevention Quality Indicators (PQI) admission rates were higher for African Americans (around 16.5/1000) than for whites (around 15/1000). By 2009, the overall and the chronic PQI admission rates declined significantly for whites but not for African Americans.
AHRQ-authored.
Citation: Mukamel DB, Ladd H, Li Y .
Have racial disparities in ambulatory care sensitive admissions abated over time?
Med Care 2015 Nov;53(11):931-9. doi: 10.1097/mlr.0000000000000426..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Quality Indicators (QIs), Racial and Ethnic Minorities, Quality of Care
Olfson M, Wang S, Blanco C
National trends in hospital-treated self-harm events among middle-aged adults.
This study assessed national trends in hospital-treated self-harm events focusing on adults aged 45-64years. Between 2001 and 2011, there was a disproportionate national increase in hospital-treated self-harm events among middle-aged adults that mirrored national trends in suicide. The increase was largely accounted for by an overall increase in mental health hospitalizations of middle-aged adults.
AHRQ-funded; HS021112.
Citation: Olfson M, Wang S, Blanco C .
National trends in hospital-treated self-harm events among middle-aged adults.
Gen Hosp Psychiatry 2015 Nov-Dec;37(6):613-9. doi: 10.1016/j.genhosppsych.2015.08.004.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Behavioral Health, Hospitalization
Shrestha S, Foxman B, Berus J
AHRQ Author: Steiner C
The role of influenza in the epidemiology of pneumonia.
The researchers used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. They concluded that influenza infection substantially enhances the risk of pneumonia, though only for a short period.
AHRQ-authored.
Citation: Shrestha S, Foxman B, Berus J .
The role of influenza in the epidemiology of pneumonia.
Sci Rep 2015 Oct 21;5:15314. doi: 10.1038/srep15314.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Influenza, Pneumonia
Aparicio HJ, Carr BG, Kasner SE
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
The researechers found that racial disparities in intravenous recombinant tissue plasminogen activator (rt-PA) use were not reduced by presentation to primary stroke centers (PSCs). Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
AHRQ-funded; HS018362; HS017960; HS013852.
Citation: Aparicio HJ, Carr BG, Kasner SE .
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
J Am Heart Assoc 2015 Oct 14;4(10):e001877. doi: 10.1161/jaha.115.001877.
.
.
Keywords: Healthcare Delivery, Disparities, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Stroke
Steiner CA, Maggard-Gibbons M, Raetzman SO
Return to acute care following ambulatory surgery.
This study determined the rates of all-cause, unplanned revisits (i.e., not for routine medical care) within 30 days of ambulatory surgery and whether revisits were related to the operation. It found that acute care revisits following ambulatory operations in low-risk patients occurred with notable frequency across 6 diverse types of operations.
AHRQ-authored
Citation: Steiner CA, Maggard-Gibbons M, Raetzman SO .
Return to acute care following ambulatory surgery.
JAMA 2015 Oct 6;314(13):1397-9. doi: 10.1001/jama.2015.12210..
Keywords: Healthcare Cost and Utilization Project (HCUP), Ambulatory Care and Surgery, Surgery, Adverse Events
Singh JA, Ramachandran R
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
The authors assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. They noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA and concluded that age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
Bone Joint J 2015 Oct;97-b(10):1385-9. doi: 10.1302/0301-620x.97b10.35696.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Orthopedics, Surgery
Carls GS, Henke RM, Karaca Z
AHRQ Author: Karaca Z, Wong HS
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
The researchers assessed the association between unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995–2011. They found that for both adults and seniors, a 1 percent increase in the unemployment rate was associated with a statistically significant decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Carls GS, Henke RM, Karaca Z .
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
Health Serv Res 2015 Oct;50(5):1688-709. doi: 10.1111/1475-6773.12298..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Healthcare Utilization, Hospitalization
Smith MW, Friedman B, Karaca Z
AHRQ Author: Friedman B, Karaca Z, Wong HS
Predicting inpatient hospital payments in the United States: a retrospective analysis.
The researchers evaluated whether payment-to-charge ratios (PCRs) can be predicted for hospitals in States that do not provide detailed financial data. They found that inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance.
AHRQ-authored.
Citation: Smith MW, Friedman B, Karaca Z .
Predicting inpatient hospital payments in the United States: a retrospective analysis.
BMC Health Serv Res 2015 Sep 10;15(1):372. doi: 10.1186/s12913-015-1040-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Healthcare Costs, Hospitalization
Maradit kremers H, Larson DR, Crowson CS
AHRQ Author: Washington RE, Steiner CA
Prevalence of total hip and knee replacement in the United States.
The study’s objective was to estimate the prevalence of total hip and total knee replacement in the United States. It found that the 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83 percent and 1.52 percent, respectively. Prevalence was higher among women than among men and increased with age.
AHRQ-authored
Citation: Maradit kremers H, Larson DR, Crowson CS .
Prevalence of total hip and knee replacement in the United States.
J Bone Joint Surg Am 2015 Sep 2;97(17):1386-97. doi: 10.2106/jbjs.n.01141..
Keywords: Healthcare Cost and Utilization Project (HCUP), Arthritis, Surgery
Vickers BP, Shi J, Lu B
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
The researchers used National Emergency Department Sample (NEDS) data to explore the hypothesis that severely injured trauma victims properly triaged to a level I or level II trauma center have significantly lower odds of death than those undertriaged to a non-trauma center. They found that trauma patients with Injury Severity Score of greater than 25 received most benefit from proper triage. Efforts to reduce undertriage should focus on this population.
AHRQ-funded; HS022277.
Citation: Vickers BP, Shi J, Lu B .
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
Am J Emerg Med 2015 Sep;33(9):1158-65. doi: 10.1016/j.ajem.2015.05.010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Trauma, Comparative Effectiveness, Mortality
Weinberger DM, Warren JL, Steiner CA
AHRQ Author: Steiner CA
Reduced-dose schedule of prophylaxis based on local data provides near-optimal protection against respiratory syncytial virus.
The researchers considered whether a reduced- dose schedule tailored to the local RSV season in the continental United States would provide adequate protection. They found that a 4-dose schedule of prophylactic injections timed with local RSV epidemics could provide protection comparable to 5 doses and could be considered as a way to improve the cost-effectiveness of prophylaxis.
AHRQ-authored.
Citation: Weinberger DM, Warren JL, Steiner CA .
Reduced-dose schedule of prophylaxis based on local data provides near-optimal protection against respiratory syncytial virus.
Clin Infect Dis 2015 Aug 15;61(4):506-14. doi: 10.1093/cid/civ331..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Newborns/Infants, Medication
Mehta AB, Syeda SN, Bajpayee L
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
This study investigated trends in tracheostomy use, timing, and outcomes in the United States. It found that over the past two decades, tracheostomy use rose substantially in the United States until 2008, when use began to decline. In addition, there was an observed dramatic increase in discharge of tracheostomy patients to long-term care facilities.
AHRQ-funded; HS020672.
Citation: Mehta AB, Syeda SN, Bajpayee L .
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
Am J Respir Crit Care Med 2015 Aug 15;192(4):446-54. doi: 10.1164/rccm.201502-0239OC..
Keywords: Healthcare Cost and Utilization Project (HCUP), Outcomes, Healthcare Utilization, Respiratory Conditions
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
AHRQ-funded; H0S19455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data
Pine M, Kowlessar NM, Salemi JL
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. The authors concluded that creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources.
AHRQ-funded
Citation: Pine M, Kowlessar NM, Salemi JL .
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Health Serv Res 2015 Aug;50 Suppl 1:1300-21. doi: 10.1111/1475-6773.12330..
Keywords: Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Patient-Centered Outcomes Research, Data
Andrews RM, Schulman KA
AHRQ Author: Andrews RM
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
To foster successful approaches to enhancing state data, AHRQ awarded eight 3-year grants to explore methods to improve the clinical content and race/ethnicity information in these databases. This editorial announces an HSR Special Issue, sponsored by AHRQ, that focuses on the products and lessons learned from these grant projects. Seven articles cover background information on statewide hospital discharge data and the grant program aims, challenges, and lessons learned.
AHRQ-authored.
Citation: Andrews RM, Schulman KA .
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
Health Serv Res 2015 Aug;50 Suppl 1:1265-72. doi: 10.1111/1475-6773.12342..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Improvement, Racial and Ethnic Minorities
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Berry JG, Zaslavsky AM, Toomey SL
Recognizing differences in hospital quality performance for pediatric inpatient care.
This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3,974 hospitals in 44 states in the 2009 Kids’ Inpatient Database. It found that most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modest differences in performance from average, but most condition-specific measures do not.
AHRQ-funded; HS020513.
Citation: Berry JG, Zaslavsky AM, Toomey SL .
Recognizing differences in hospital quality performance for pediatric inpatient care.
Pediatrics 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Quality of Care
Andrews RM
AHRQ Author: Andrews RM
Statewide hospital discharge data: Collection, use, limitations, and improvements.
The purpose of the article is to provide background information on statewide hospital discharge data and the context for the other articles in this special issue of HSR that focus on the products and lessons learned by the Enhanced State Data grantees. The author provides an overview of statewide hospital discharge data, including content and coverage, and its evolution and improvement over time.
AHRQ-authored
Citation: Andrews RM .
Statewide hospital discharge data: Collection, use, limitations, and improvements.
Health Serv Res 2015 Aug;50 Suppl 1:1273-99. doi: 10.1111/1475-6773.12343..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Data
Peng J, Wheeler K, Shi J
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Its results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified.
AHRQ-funded; HS022277.
Citation: Peng J, Wheeler K, Shi J .
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
PLoS One 2015 Jul 31;10(7):e0134821. doi: 10.1371/journal.pone.0134821..
Keywords: Mortality, Healthcare Cost and Utilization Project (HCUP), Trauma, Emergency Medical Services (EMS), Emergency Department
Hicks CW, Hashmi ZG, Hui X
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
This study sought to determine if differences in outcomes at treating facilities can help explain age-based racial disparities in survival after trauma. For example, among patients older than 65 years, blacks had decreased odds of mortality compared with whites. It found that facility-based differences do not seem to explain this paradoxical age-based racial disparity after trauma observed in the older population.
AHRQ-funded; HS017952.
Citation: Hicks CW, Hashmi ZG, Hui X .
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
AHRQ-funded; HS017952..
Keywords: Disparities, Comparative Effectiveness, Patient-Centered Outcomes Research, Healthcare Cost and Utilization Project (HCUP)
Meddings J, Reichert H, Rogers MA
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
This study assessed the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. It found that the total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV.
AHRQ-funded; HS019767; HS018334.
Citation: Meddings J, Reichert H, Rogers MA .
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
J Am Geriatr Soc 2015 Jul;63(7):1407-12. doi: 10.1111/jgs.13475..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Pressure Ulcers, Patient Safety, Healthcare-Associated Infections (HAIs)
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
Because laboratory testing and coding for rotavirus are not routinely performed for patients with diarrhea, the researchers examined both all-cause acute gastroenteritis and rotavirus-coded hospitalizations among children younger than 5 years from 2000 through 2012. They found that, in 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations.
AHRQ-authored.
Citation: Leshem E, Tate JE, Steiner CA .
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
JAMA 2015 Jun 9;313(22):2282-4. doi: 10.1001/jama.2015.5571..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination, Children/Adolescents, Adverse Events
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
AHRQ-funded; HS020667.
Citation: Duseja R, Bardach NS, Lin GA .
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department, Hospitalization, Hospital Readmissions