National Healthcare Quality and Disparities Report
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Topics
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 164 Research Studies DisplayedKim HS, Monte AA
Colorado cannabis legalization and its effect on emergency care.
The authors noted that increased marijuana use after legalization has been accompanied by increases in emergency department visits and hospitalizations due to marijuana intoxication. They recommended that providers in states with impending legalization measures should become familiar with the symptoms and management of acute marijuana intoxication, as well as understand the effects on chronic diseases frequently observed in the emergency department. Further, they suggested that residency program directors should make an effort to integrate this topic into their residency curricula.
AHRQ-funded; HS000078.
Citation: Kim HS, Monte AA .
Colorado cannabis legalization and its effect on emergency care.
Ann Emerg Med 2016 Jul;68(1):71-5. doi: 10.1016/j.annemergmed.2016.01.004.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Policy, Substance Abuse
Shah MP, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
The researchers compared the rates of gastroenteritis- and rotavirus-coded ED visits among children <5 years of age in pre-rotavirus vaccine (2003 to 2006) with those in postvaccine (2008-2013) years; 2007 was excluded as a transition year They concluded that. ED visits for gastroenteritis in US children have declined since the introduction of rotavirus vaccine.
AHRQ-authored.
Citation: Shah MP, Tate JE, Steiner CA .
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
Pediatr Infect Dis J 2016 Jul;35(7):782-6. doi: 10.1097/inf.0000000000001175.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Vaccination, Emergency Medical Services (EMS), Digestive Disease and Health
Melvin CL, Saef SH, Pierce HO
Health information exchange in the ED: what do ED clinicians think?
The researchers investigated reasons for low Carolina eHealth Alliance health information exchange (CeHA-HIE)utilization. They found that most emergency department clinicians believed the system added value to their work but preferred better integration with their electronic medical records systems.
AHRQ-funded; HS019339; HS023047.
Citation: Melvin CL, Saef SH, Pierce HO .
Health information exchange in the ED: what do ED clinicians think?
South Med J 2016 Jul;109(7):419-26. doi: 10.14423/smj.0000000000000466.
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Keywords: Health Information Exchange (HIE), Emergency Department, Electronic Health Records (EHRs), Emergency Medical Services (EMS)
Blecker S, Gavin NP, Park H
Observation units as substitutes for hospitalization or home discharge.
The purpose of this study is to determine the effect of the availability of observation units on hospitalizations and discharges to home for emergency department (ED) patients. The authors concluded that half of ED visits for chest pain that resulted in an observation unit admission were made by patients who may have been discharged home had the observation unit not been available.
AHRQ-funded; HS023683.
Citation: Blecker S, Gavin NP, Park H .
Observation units as substitutes for hospitalization or home discharge.
Ann Emerg Med 2016 Jun;67(6):706-13.e2. doi: 10.1016/j.annemergmed.2015.10.025.
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Keywords: Hospitalization, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS)
Berian JR, Paruch JL, Cohen ME
Does performance vary within the same hospital when separately examining different patient subgroups?
The researchers sought to determine whether performance differs within a given hospital for 6 contrasting patient subgroups and to identify the percentage of hospitals with greater than chance differences in performance. They found that overall quality differed for elderly vs nonelderly, renal insufficiency vs normal renal function patients, cancer vs noncancer, and emergency vs nonemergency. They concluded that quality programs can consider separate reports for these subgroups to identify opportunities for quality improvement.
AHRQ-funded; HS021857.
Citation: Berian JR, Paruch JL, Cohen ME .
Does performance vary within the same hospital when separately examining different patient subgroups?
J Am Coll Surg 2016 May;222(5):790-97.e1. doi: 10.1016/j.jamcollsurg.2016.01.057.
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Keywords: Emergency Medical Services (EMS), Hospitals, Outcomes, Quality Improvement, Social Determinants of Health
Byczkowski TL, Gillespie GL, Kennebeck SS
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
The objective of this study was to identify dimensions of family-centered care important to parents in pediatric emergency care and compare them to those currently defined. The authors concluded that the resulting dimensions provide a framework for measuring and improving the delivery of family-centered pediatric emergency care.
AHRQ-funded; HS019037.
Citation: Byczkowski TL, Gillespie GL, Kennebeck SS .
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
Acad Pediatr 2016 May-Jun;16(4):327-35. doi: 10.1016/j.acap.2015.08.011.
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Keywords: Healthcare Delivery, Children/Adolescents, Emergency Medical Services (EMS), Patient Experience, Children/Adolescents
Hodell E, Hughes SD, Corry M
Paramedic perspectives on barriers to prehospital acute stroke recognition.
The researchers aimed to understand systematically the challenges and barriers faced by paramedics in recognizing stroke presentations in the field. They concluded that while challenges to stroke recognition in the field were slightly different for rural and urban emergency medical service providers, participants concurred that timely, systematic feedback on individual patients and case-based training would strengthen early stroke recognition skills.
AHRQ-funded; HS017965.
Citation: Hodell E, Hughes SD, Corry M .
Paramedic perspectives on barriers to prehospital acute stroke recognition.
Prehosp Emerg Care 2016 May-Jun;20(3):415-24. doi: 10.3109/10903127.2015.1115933.
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Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Healthcare Delivery, Stroke, Training
Flottemesch TJ, Raetzman S, Heslin KC
AHRQ Author: Heslin KC
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Reflecting perceived undertriage to trauma centers (TCs) for older adults, the American College of Surgeons' Committee on Trauma and the Center for Disease Control revised field triage guidelines in 2011 with additional emphasis on direct transport to a Level I or II trauma center. Researchers examined whether age-based disparities in TC care for severe head injury decreased. Although patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age-based disparities persisted.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Flottemesch TJ, Raetzman S, Heslin KC .
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Acad Emerg Med 2016 Apr;24(4):447-57. doi: 10.1111/acem.13150.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Elderly, Brain Injury, Emergency Medical Services (EMS)
Leyenaar JK, Lagu T, Lindenauer PK
Direct admission to the hospital: an alternative approach to hospitalization.
The authors discussed the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to the hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. They proposed that transitions of care research and quality improvement be expanded to address transitions into the hospital.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Lagu T, Lindenauer PK .
Direct admission to the hospital: an alternative approach to hospitalization.
J Hosp Med 2016 Apr;11(4):303-5. doi: 10.1002/jhm.2512.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Transitions of Care
Dimou FM, Adhikari D, Mehta HB
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
To better understand underuse of cholecystectomy, the researchers examined physician follow-up patterns after emergency department (ED) visits for symptomatic gallstones. They found that fewer than half of patients were evaluated by a surgeon after an initial ED visit for symptomatic gallstones. Patients who did not have physician follow-up were most likely to require emergent cholecystectomy, suggesting inappropriate ED discharge and highlighting the need for timely follow-up.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
J Am Coll Surg 2016 Apr;222(4):377-84. doi: 10.1016/j.jamcollsurg.2015.12.011.
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Keywords: Elderly, Emergency Medical Services (EMS), Patient-Centered Outcomes Research, Practice Patterns
Donnelly JP, Franco RA, Wang HE
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Hepatitis C virus (HCV) infection is a growing problem, disproportionately affecting those born between 1945 and 1965. Here, we demonstrate the wide geographic reach and surveillance potential of emergency department-based screening and identify areas of elevated HCV infection in central Alabama that were socioeconomically disadvantaged compared with surrounding communities.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Franco RA, Wang HE .
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Clin Infect Dis 2016 Mar 1;62(5):613-6. doi: 10.1093/cid/civ984.
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Keywords: Hepatitis, Screening, Emergency Department, Emergency Medical Services (EMS)
Taylor RA, Pare JR, Venkatesh AK
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing clinical decision rules (CDRs) and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. It concluded that this approach outperformed existing CDRs as well as traditional analytic techniques for predicting in-hospital mortality of ED patients with sepsis.
AHRQ-funded; HS021271.
Citation: Taylor RA, Pare JR, Venkatesh AK .
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
Acad Emerg Med 2016 Mar;23(3):269-78. doi: 10.1111/acem.12876.
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Keywords: Emergency Medical Services (EMS), Mortality, Clinical Decision Support (CDS), Sepsis, Health Information Technology (HIT)
Chen LY, Crum RM, Strain EC
Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants.
Little is known regarding the temporal trends in prescriptions, nonmedical use, and emergency department (ED) visits involving prescription stimulants in the United States. The study examined these 3 national trends involving dextroamphetamine-amphetamine and methylphenidate in adults and adolescents. It found that trends in prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits.
AHRQ-funded; HS0189960.
Citation: Chen LY, Crum RM, Strain EC .
Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants.
J Clin Psychiatry 2016 Mar;77(3):e297-304. doi: 10.4088/JCP.14m09291.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medication, Substance Abuse
Johnson TJ, Hickey RW, Switzer GE
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
The researchers sought to determine if physicians have different levels of implicit racial bias post-ED shift versus preshift and to examine associations between demographics and cognitive stressors (e.g., fatigue, stress, time pressure, and complex decision-making) with bias. They concluded that resident implicit bias remained stable overall preshift to postshift, cognitive stressors (overcrowding and patient load) were associated with increased implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Hickey RW, Switzer GE .
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
Acad Emerg Med 2016 Mar;23(3):297-305. doi: 10.1111/acem.12901.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Stress, Provider: Health Personnel
Shaw JJ, Psoinos CM, Santry HP
It's all about location, location, location: A new perspective on trauma transport.
The objective of this study was to determine the effect of aeromedical transport on trauma mortality when accounting for geographic factors. It concluded that helicopter transport does not impart a survival benefit for trauma patients when geographic considerations are taken into account.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Psoinos CM, Santry HP .
It's all about location, location, location: A new perspective on trauma transport.
Ann Surg 2016 Feb;263(2):413-8. doi: 10.1097/sla.0000000000001265..
Keywords: Trauma, Emergency Medical Services (EMS), Registries, Mortality, Access to Care
Meischke H, Painter I, Turner AM
Protocol: simulation training to improve 9-1-1 dispatcher identification of cardiac arrest.
The researchers aim to evaluate the use of phone-based standardized patient simulation training to improve identification of the need for Telephone-CPR (T-CPR) and shorten time to start of T-CPR instructions. They specify that the STAT-911 study will evaluate if over-the-phone simulation training with standardized patients can improve 9-1-1 dispatchers' ability identify the need for, and promptly begin T-CPR.
AHRQ-funded; HS021658.
Citation: Meischke H, Painter I, Turner AM .
Protocol: simulation training to improve 9-1-1 dispatcher identification of cardiac arrest.
BMC Emerg Med 2016 Feb 1;16:9. doi: 10.1186/s12873-016-0073-6.
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Keywords: Cardiovascular Conditions, Emergency Medical Services (EMS), Patient Safety, Training
Dresden SM, Feinglass JM, Kang R
Ambulatory care sensitive hospitalizations through the emergency department by payer: comparing 2003 and 2009.
This study compared rates of ED ambulatory care sensitive hospitalizations (ACSHs) for 2003 and 2009 among patients 18 to 64 years of age with private insurance, Medicaid, or no insurance.It found that an increase in the uninsured population was associated with an increase in the rate of ED ACSH for uninsured patients.
AHRQ-funded; HS000078.
Citation: Dresden SM, Feinglass JM, Kang R .
Ambulatory care sensitive hospitalizations through the emergency department by payer: comparing 2003 and 2009.
J Emerg Med 2016 Jan;50(1):135-42. doi: 10.1016/j.jemermed.2015.02.047.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Hospitalization, Emergency Medical Services (EMS)
Nelson SD, Del Fiol G, Hanseler H
Software prototyping: a case report of refining user requirements for a health information exchange dashboard.
The researchers describe the design of an health information exchange (HIE) dashboard and the refinement of user requirements through rapid prototyping. Survey results from three users provided useful feedback that was then incorporated into the design. After achieving a stable design, they used the prototype itself as the specification for development of the actual software.
AHRQ-funded; HS021472.
Citation: Nelson SD, Del Fiol G, Hanseler H .
Software prototyping: a case report of refining user requirements for a health information exchange dashboard.
Appl Clin Inform 2016 Jan;7(1):22-32. doi: 10.4338/aci-2015-07-cr-0091.
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Keywords: Health Information Technology (HIT), Health Information Exchange (HIE), Emergency Medical Services (EMS)
Chen SI, Wang Y, Dreyer R
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
The authors assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients with acute myocardial infarction (AMI) in the US and in Spain. They concluded that in the US, women were more likely than men to delay, although it was not explained by differences in insurance status. Further, the lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture.
AHRQ-funded; HS023000.
Citation: Chen SI, Wang Y, Dreyer R .
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
Am J Cardiol 2015 Dec 15;116(12):1827-32. doi: 10.1016/j.amjcard.2015.09.018.
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Keywords: Healthcare Delivery, Emergency Medical Services (EMS), Health Insurance, Heart Disease and Health, Sex Factors
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
McGeorge N, Hedge S, Berg RL
Assessment of innovative emergency department information displays in a clinical simulation center.
The authors assessed the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. They found that participants using the new displays showed improved situation awareness, demonstrating that cognitive systems engineering methods can be used to create innovative displays that better support emergency medicine tasks, without increasing workload, compared to more standard displays.
AHRQ-funded; HS020433.
Citation: McGeorge N, Hedge S, Berg RL .
Assessment of innovative emergency department information displays in a clinical simulation center.
J Cogn Eng Decis Mak 2015 Dec;9(4):329-46. doi: 10.1177/1555343415613723.
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Keywords: Healthcare Delivery, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Moore CL, Broder J, Gunn ML
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
The goal was to seek consensus in identifying and prioritizing research questions and themes that involve the comparative effectiveness of "traditional" computed tomography use versus alternative diagnostic strategies in the acute care setting. A modified Delphi technique was used that included input from emergency physicians, emergency radiologists, medical physicists, and an industry expert to achieve this.
AHRQ-funded; HS021271; HS023498.
Citation: Moore CL, Broder J, Gunn ML .
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
Acad Emerg Med 2015 Dec;22(12):1465-73. doi: 10.1111/acem.12831.
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Keywords: Comparative Effectiveness, Imaging, Critical Care, Emergency Medical Services (EMS)
McCabe AM, Kuppermann N
Generation of evidence and translation into practice: Lessons learned and future directions.
This article describes the experience of the Pediatric Emergency Care Applied Research Network (PECARN) in deriving and validating the traumatic brain injury prediction rules and how PECARN is translating these prediction rules into clinical practice. Furthermore, it discusses the potential for patient/parent shared decision-making with a focus on patient-centered outcomes in Emergency department research.
AHRQ-funded; HS023498.
Citation: McCabe AM, Kuppermann N .
Generation of evidence and translation into practice: Lessons learned and future directions.
Acad Emerg Med 2015 Dec;22(12):1372-9. doi: 10.1111/acem.12819.
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Keywords: Implementation, Evidence-Based Practice, Emergency Medical Services (EMS), Brain Injury, Children/Adolescents
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lee DC, Carr BG, Smith TE
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. Emergency volume increased nearly twice as fast at tertiary referral centers (4.8 percent) and nonurban hospitals (3.7 percent versus urban at 2.1 percent) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth.
AHRQ-funded; HS018362; HS010914.
Citation: Lee DC, Carr BG, Smith TE .
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
Popul Health Manag 2015 Dec;18(6):459-66. doi: 10.1089/pop.2014.0123.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Hospitals, Access to Care