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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (4)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (3)
- Children/Adolescents (5)
- Community-Acquired Infections (2)
- Data (1)
- Depression (1)
- Elderly (3)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Health Insurance (1)
- Heart Disease and Health (2)
- Hospitalization (6)
- Hospital Readmissions (1)
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- Infectious Diseases (1)
- Inpatient Care (2)
- Medicare (2)
- Medication (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (2)
- Neurological Disorders (1)
- Nursing Homes (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Payment (1)
- (-) Pneumonia (15)
- Prevention (2)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (5)
- Risk (1)
- Sickle Cell Disease (2)
- Surgery (3)
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
1 to 15 of 15 Research Studies DisplayedTandan M, Zimmerman S, Sloane PD
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
Pneumonia is a frequent cause of hospitalization among nursing home (NH) residents, but little information is available as to how clinical presentation and other characteristics relate to hospitalization, and the differential use of antimicrobials based on hospitalization status. This study examined how hospitalized and nonhospitalized NH residents with pneumonia differ. The investigators concluded that respiratory rate was associated with hospitalization but was not documented for more than a quarter of residents.
AHRQ-funded; HS022298.
Citation: Tandan M, Zimmerman S, Sloane PD .
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
J Am Med Dir Assoc 2020 Dec;21(12):1862-68.e3. doi: 10.1016/j.jamda.2020.07.028..
Keywords: Elderly, Nursing Homes, Pneumonia, Respiratory Conditions, Hospitalization
Klompas M, Imrey PB, Yu PC
Respiratory viral testing and antibacterial treatment in patients hospitalized with community-acquired pneumonia.
Researchers studied the frequency of respiratory viral testing and its associations with antimicrobial utilization in adult patients hospitalized with community-acquired pneumonia. They found that, of patients with pneumonia on admission, 24.5% were tested for respiratory viruses, 94.8% were tested for influenza, and 20.7% were tested for other viruses. They concluded that a minority of patients hospitalized with pneumonia were tested for respiratory viruses; only a fraction of potential viral pathogens were assayed; and patients with positive viral tests often received long antibacterial courses.
AHRQ-funded; HS025008; HS024277.
Citation: Klompas M, Imrey PB, Yu PC .
Respiratory viral testing and antibacterial treatment in patients hospitalized with community-acquired pneumonia.
Infect Control Hosp Epidemiol 2021 Jul;42(7):817-25. doi: 10.1017/ice.2020.1312..
Keywords: Pneumonia, Respiratory Conditions, Antibiotics, Medication
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Sabbagh SE, Neely J, Chow A
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Pneumocystis jirovecii pneumonia (PJP) is associated with significant morbidity and mortality in adult myositis patients; however, there are few studies examining PJP in juvenile myositis [juvenile idiopathic inflammatory myopathy (JIIM)]. The purpose of this study was to determine the risk factors and clinical phenotypes associated with PJP in JIIM. The investigators concluded that having PJP was associated with more immunosuppressive therapy, anti-MDA5 autoantibodies, Asian race and certain clinical features, including digital infarcts, cutaneous ulcerations and interstitial lung disease.
AHRQ-funded; HS000063.
Citation: Sabbagh SE, Neely J, Chow A .
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Rheumatology 2021 Feb;60(2):829-36. doi: 10.1093/rheumatology/keaa436..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Risk
Frush JM, Zhu Y, Edwards KM
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
In a studied group of children hospitalized with community-acquired pneumonia, staphylococcal pneumonia was rare but associated with adverse in-hospital outcomes. Despite this low prevalence, use of antistaphylococcal antibiotics was common. The authors recommended efforts to minimize overuse of antistaphylococcal antibiotics while also ensuring adequate treatment for pathogen-specific diseases.
AHRQ-funded; HS022342.
Citation: Frush JM, Zhu Y, Edwards KM .
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
J Hosp Med 2018 Dec;13(12):848-52. doi: 10.12788/jhm.3093..
Keywords: Children/Adolescents, Infectious Diseases, Pneumonia, Methicillin-Resistant Staphylococcus aureus (MRSA), Community-Acquired Infections, Hospitalization, Antibiotics, Medication
Heslin KC, Owens PL, Simpson LA
AHRQ Author: Heslin KC Owens PL
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
The authors describe trends in unplanned 30-day all-condition hospital readmissions for children aged 1 to 17 years between 2009 and 2014. Using HCUP data, they found that the rate of readmission was essentially stable between 2009 and 2014. In 2009, the most common reason for readmission was sickle cell anemia, whereas in 2014 the most common reason was epilepsy. Pneumonia fell from the second to the sixth most common reason for readmission over this period. The authors suggest that their study provides a baseline assessment for examining trends in 30-day unplanned pediatric readmissions, an important quality metric as the provisions of the Children's Health Insurance Program Reauthorization Act and the Affordable Care Act are changed and implemented in the future.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Simpson LA .
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
Acad Pediatr 2018 Nov - Dec;18(8):857-72. doi: 10.1016/j.acap.2018.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Hospitalization, Hospitals, Sickle Cell Disease, Pneumonia, Neurological Disorders
Schmajuk G, Yazdany J
Further lessons in pneumocystis pneumonia prophylaxis.
This paper discusses an teachable moment case study by LoPiccolo, et al, published in 2018 in the Journal of the American Medical Association Internal Medicine, entitled “Corticosteroid Use and Pneumocystis Pneumonia Prophylaxis: A Teachable Moment.”
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Further lessons in pneumocystis pneumonia prophylaxis.
JAMA Intern Med 2018 Nov;178(11):1565-66. doi: 10.1001/jamainternmed.2018.5930..
Keywords: Pneumonia, Prevention
Likosky DS, Harrington SD, Cabrera L
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
This study examined post cardiac surgery pneumonia rates associated with participation in a statewide, quality improvement collaborative relative to a national physician reporting program. The investigators concluded that participation in a physician-led collaborative was associated with significant reductions in pneumonia relative to a national quality reporting program. They suggest that interventions including collaborative learning may yield superior outcomes relative to solely using physician feedback reporting.
AHRQ-funded; HS022535.
Citation: Likosky DS, Harrington SD, Cabrera L .
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e004756. doi: 10.1161/circoutcomes.118.004756..
Keywords: Outcomes, Patient Safety, Pneumonia, Quality of Care, Quality Improvement, Surgery
Weir RE, Lyttle CS, Meltzer DO
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
In this observational study, the investigators sought to compare the relative value of several methodologies by which comorbidities may be ascertained. The authors concluded that although comorbidities derived through administrative data did produce an area under the curve greater than chart review, their analyses suggested a coding bias in several comorbidities with a paradoxically protective effect. They assert that chart review, while labor and resource intensive, may be the ideal method for ascertainment of clinically relevant comorbidities.
AHRQ-funded; HS016948; HS010597.
Citation: Weir RE, Lyttle CS, Meltzer DO .
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
Med Care 2018 Nov;56(11):950-55. doi: 10.1097/mlr.0000000000000989..
Keywords: Community-Acquired Infections, Hospitalization, Mortality, Pneumonia
Desai NR, Ott LS, George EJ
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
The objectives of this study were to investigate the association between hospital-level 30-day risk-standardized mortality rates (RSMRs) and 30-day risk-standardized payments (RSPs) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNA); to characterize patterns of value in care; and to identify hospital characteristics associated with high-value care (defined by having lower than median RSMRs and RSPs).
AHRQ-funded; HS023000.
Citation: Desai NR, Ott LS, George EJ .
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
JAMA Netw Open 2018 Oct 5;1(6):e183519. doi: 10.1001/jamanetworkopen.2018.3519..
Keywords: Cardiovascular Conditions, Elderly, Hospitalization, Hospitals, Heart Disease and Health, Inpatient Care, Medicare, Mortality, Pneumonia
Thompson MP, Cabrera L, Strobel RJ
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Postoperative pneumonia is the most common healthcare-associated infection in cardiac surgical patients, yet their impact across a 90-day episode of care remains unknown. The objective of this study was to examine the relationship between pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. The investigators concluded that postoperative pneumonia was associated with significantly higher 90-day episode payments and inferior outcomes at the patient and hospital level.
AHRQ-funded; HS022535.
Citation: Thompson MP, Cabrera L, Strobel RJ .
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Circ Cardiovasc Qual Outcomes 2018 Sep;11(9):e004818. doi: 10.1161/circoutcomes.118.004818..
Keywords: Elderly, Surgery, Medicare, Cardiovascular Conditions, Heart Disease and Health, Pneumonia, Payment, Healthcare Costs, Outcomes, Healthcare-Associated Infections (HAIs), Health Insurance
Reeves SL, Tribble AC, Madden B
Antibiotic prophylaxis for children with sickle cell anemia.
This study calculated the proportion of children with sickle cell anemia (SCA) who received at least 300 days of antibiotic prophylaxis against invasive pneumococcal disease and identified predictors of receipt. Children with SCA between 3 months and 5 years old were identified by the presence of three or more Medicaid claims with a diagnosis of SCA within a calendar year in six states. Receipt of antibiotics was identified through claims for filled prescriptions. The authors conclude that antibiotic prophylaxis rates are low among children with SCA; more healthcare encounters may offer opportunities for increased intervention. Potential predictors were identified as age, sex, year, state, and health services usage.
AHRQ-funded; HS020516.
Citation: Reeves SL, Tribble AC, Madden B .
Antibiotic prophylaxis for children with sickle cell anemia.
Pediatrics 2018 Mar;141(3). doi: 10.1542/peds.2017-2182..
Keywords: Sickle Cell Disease, Children/Adolescents, Antibiotics, Prevention, Pneumonia, Medication
Eisler L, Huang G, Lee KM
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source. The investigators found that International Classification of Diseases, Ninth Revision codes for aspiration used as a secondary data source were nonspecific for perioperative aspiration, but when combined with record review yielded a 30% increase in identified cases of aspiration over quality assurance data alone.
AHRQ-funded; HS022941.
Citation: Eisler L, Huang G, Lee KM .
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
Paediatr Anaesth 2018 Mar;28(3):218-25. doi: 10.1111/pan.13319..
Keywords: Adverse Events, Children/Adolescents, Data, Pneumonia, Respiratory Conditions
Brescia AA, Rankin JS, Cyr DD
Determinants of variation in pneumonia rates after coronary artery bypass grafting.
In this study, investigators determined to what extent patient risk factors account for hospital variation in pneumonia rates. Their findings suggested that patient risk profiles only account for a fraction of hospital variation in pneumonia rates. The investigators assert that enhanced understanding of other contributory factors (eg, processes of care) is required to lessen the likelihood of such nosocomial infections.
AHRQ-funded; HS022535.
Citation: Brescia AA, Rankin JS, Cyr DD .
Determinants of variation in pneumonia rates after coronary artery bypass grafting.
Ann Thorac Surg 2018 Feb;105(2):513-20. doi: 10.1016/j.athoracsur.2017.08.012..
Keywords: Adverse Events, Cardiovascular Conditions, Pneumonia, Surgery
DeWaters AL, Chansard M, Anzueto A
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in veterans hospitalized with pneumonia. It found that patients with untreated depression had a significantly higher 30-day and 90-day mortality, as well as significantly higher intensive care unit admission rates, compared to patients with treated depression.
AHRQ-funded; HS022418.
Citation: DeWaters AL, Chansard M, Anzueto A .
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
Am J Med Sci 2018 Jan;355(1):21-26. doi: 10.1016/j.amjms.2017.08.015.
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Keywords: Depression, Hospitalization, Patient-Centered Outcomes Research, Pneumonia