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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedMeille G, Decker SL, Owens PL
AHRQ Author: Meille G, Decker SL, Owens PL
COVID-19 admission rates and changes in US hospital inpatient and intensive care unit occupancy.
The objective of this cross-sectional study was to measure the relationship between COVID-19 admission rates and hospital occupancy in different US areas at different time periods during 2020. Data were taken from the HCUP State Inpatient Databases for patients in nonfederal acute care hospitals. The results showed that hospital occupancy decreased during weeks with low COVID-19 admissions and increased during weeks with high COVID-19 admissions; the largest changes occurred early in the pandemic. The authors concluded that their findings suggest that COVID-19 surges strained intensive care unit capacity and were associated with decreases in the number of surgical patients. These occupancy fluctuations may have affected quality of care and hospital finances.
AHRQ-authored.
Citation: Meille G, Decker SL, Owens PL .
COVID-19 admission rates and changes in US hospital inpatient and intensive care unit occupancy.
JAMA Health Forum 2023 Dec; 4(12):e234206. doi: 10.1001/jamahealthforum.2023.4206..
Keywords: COVID-19, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Hospitals
Kannan S, Song Z
Changes in out-of-pocket costs for US hospital admissions between December and January every year.
Out-of-pocket costs for ICU care may be large at the beginning of the year due to high insurance deductibles that reset every year for US patients, and the expensive nature of ICU care. The purpose of this cross-sectional study was to explore cost-sharing changes from December to January for ICU admissions and non -ICU admissions among adults with employer-sponsored insurance. Among aggregate ICU hospitalizations, total cost-sharing averaged $1079 in December and $1871 in January, a 73.4% increase. Among non-ICU hospitalizations, total cost-sharing averaged $1043 in December and $1683 in January, a 61.3% increase. These increases and differences between ICU and non-ICU hospitalizations were greater among patients with high deductible health plans (HDHPs). For patients with HDHPs requiring an ICU stay, cost-sharing averaged $3093 per hospitalization in January vs $1301 in December.
AHRQ-funded; HS024072.
Citation: Kannan S, Song Z .
Changes in out-of-pocket costs for US hospital admissions between December and January every year.
JAMA Health Forum 2023 May 5; 4(5):e230784. doi: 10.1001/jamahealthforum.2023.0784..
Keywords: Healthcare Costs, Hospitals, Hospitalization, Intensive Care Unit (ICU)
Valley TS, Schutz A, Miller J
Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.
In order to understand factors influencing how intensive care unit (ICU) admission decisions are made, researchers conducted qualitative analysis of eight U.S. hospitals. Semi-structured, one-on-one interviews with 87 participants were supplemented by site visits and clinical observations. Four hospital-level factors were identified which influenced ICU admission decisionmaking. The researchers concluded that healthcare systems should evaluate use of ICU care and establish institutional patterns to ensure that ICU admission decisions are patient-centered as well as account for resources and hospital-specific constraints.
AHRQ-funded; HS028038.
Citation: Valley TS, Schutz A, Miller J .
Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.
Intensive Care Med 2023 May; 49(5):505-16. doi: 10.1007/s00134-023-07031-w..
Keywords: Intensive Care Unit (ICU), Hospitals, Shared Decision Making, Hospitalization
Leyenaar JK, Hill V, Lam V
Direct admission to hospital for children in the United States.
The purpose of this paper is to develop a policy statement to present recommendations to optimize the quality and safety of this hospital admission approach for children, as one in four unscheduled hospital admissions for children and adolescents in the United States occurs via direct admission, defined as hospital admission without first receiving care in the hospital's emergency department. Recommendations in the proposed policy statement provide guidance related to: (i) direct admission written guidelines, (ii) clear systems of communication between members of the health care team and with families of children requiring admission, (iii) triage systems to identify patient acuity and disease severity, (iv) identification of hospital resources needed to support direct admission systems of care, (v) consideration of patient populations that may be at increased risk of adverse outcomes during the hospital admission process, (vi) addressing the relevance of local factors and resources, and (vii) ongoing evaluation of direct admission processes and outcomes. The recommendations are intended to support the implementation of safe direct admission processes and to foster awareness of outcomes associated with this common portal of hospital admission.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Hill V, Lam V .
Direct admission to hospital for children in the United States.
Pediatrics 2023 Mar;151(3):e2022060973. doi: 10.1542/peds.2022-060973.
Keywords: Children/Adolescents, Hospitals, Hospitalization
Kelly MM, Hoonakker PLT, Nacht CL
Parent perspectives on sharing pediatric hospitalization clinical notes.
This qualitative study sought to identify parent perceptions of the benefits and challenges of real-time note access during their child's hospitalization and strategies to optimize note-sharing at the bedside. The study conducted 60-minute interviews with 28 parents who were given access to their child's admission and daily progress notes on a bedside tablet (iPad) and interviewed upon discharge. The parents described 6 benefits of having note access, which: provided a recap and improved their knowledge about their child's care plan, enhanced communication, facilitated empowerment, increased autonomy, and incited positive emotions. Potential challenges described included: causing confusion, hindering communication with the health care team, highlighting problems with note content, and inciting negative emotions. The parents recommended 4 strategies to support sharing: provide preemptive communication about expectations, optimize the note release process, consider parent-friendly note template modifications, and offer informational resources for parents.
AHRQ-funded; HS027214.
Citation: Kelly MM, Hoonakker PLT, Nacht CL .
Parent perspectives on sharing pediatric hospitalization clinical notes.
Pediatrics 2023 Jan; 151(1). doi: 10.1542/peds.2022-057756..
Keywords: Children/Adolescents, Hospitals, Clinician-Patient Communication, Communication, Hospitalization