National Healthcare Quality and Disparities Report
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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
551 to 569 of 569 Research Studies DisplayedNguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams
Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L
Is low health literacy associated with increased emergency department utilization and recidivism?
The study objective was to determine whether patients with low health literacy have higher emergency department (ED) use and higher ED recidivism than patients with adequate health literacy. It found that patients with inadequate health literacy had higher ED use compared to those with adequate health literacy.
AHRQ-funded; HS020309
Citation: Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L .
Is low health literacy associated with increased emergency department utilization and recidivism?
Acad Emerg Med. 2014 Oct;21(10):1109-15. doi: 10.1111/acem..
Keywords: Health Literacy, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Friermuth CE, Haywood C, Jr., Silva S
Attitudes toward patients with sickle cell disease in a multicenter sample of emergency department providers.
The authors aimed to validate a survey that measures attitudes toward sickle cell disease (SCD) patients among emergency department (ED) providers and to compare differences in attitude scores between provider types. They found that, among ED providers, this scale identified a dimension not observed in research with the original instrument among internal medicine providers. They concluded that provider attitudes influence patient-provider interactions and quality of care.
AHRQ-funded; HS019646.
Citation: Friermuth CE, Haywood C, Jr., Silva S .
Attitudes toward patients with sickle cell disease in a multicenter sample of emergency department providers.
Adv Emerg Nurs J 2014 Oct-Dec;36(4):335-47. doi: 10.1097/tme.0000000000000036.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Provider: Health Personnel, Sickle Cell Disease
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Hernandez-Boussard T, Burns CS, Wang NE
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The authors tested the impact of the Affordable Care Act (ACA) on how young adults used ED services. They found that the largest relative decreases were found in women and blacks. This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults across three states in 2011.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Burns CS, Wang NE .
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
Health Aff 2014 Sep;33(9):1648-54. doi: 10.1377/hlthaff.2014.0103.
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Keywords: Emergency Department, Health Insurance, Policy, Healthcare Cost and Utilization Project (HCUP), Young Adults
Johnson EK, Graham DA, Chow JS
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
The researchers describe the national use of computed tomography (CT) versus ultrasound imaging for pediatric patients seen at emergency departments (EDs) for suspected urolithiasis (SU) during the period 2006-2010. Use of CT was much higher than use of ultrasound, although it dropped off after 2007. Lowest CT use was seen at EDs that care for more children.
AHRQ-funded; HS019485
Citation: Johnson EK, Graham DA, Chow JS .
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
J Urol. 2014 Jul;192(1):200-6. doi: 10.1016/j.juro.2014.01.028..
Keywords: Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Imaging, Children/Adolescents, Practice Patterns
Newman-Toker DE, Moy E, Valente E
AHRQ Author: Moy E
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
The authors sought to estimate the frequency of missed stroke and examine associations with patient, emergency department (ED), and hospital characteristics. They estimated 15,000-165,000 misdiagnosed cerebrovascular events annually in US EDs, disproportionately presenting with headache or dizziness. They recommended that physicians evaluating these symptoms be particularly attuned to the possibility of stroke in younger, female, and non-White patients.
AHRQ-authored; AHRQ-funded; HS019252.
Citation: Newman-Toker DE, Moy E, Valente E .
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
Diagnosis 2014 Jun;1(2):155-66. doi: 10.1515/dx-2013-0038.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient Safety, Stroke
Mutter R, Clancy C
AHRQ Author: Mutter R, Clancy C
Investing in emergency medicine to improve health care for all Americans: the role of the Agency for Healthcare Research and Quality.
This article provides a description of the portfolio of emergency care-related activities that AHRQ sponsors. The discussion includes these areas: conduct of research; tool development; quality indicators; data and analytic capacity; and training of young investigators.
AHRQ-authored.
Citation: Mutter R, Clancy C .
Investing in emergency medicine to improve health care for all Americans: the role of the Agency for Healthcare Research and Quality.
Ann Emerg Med 2014 May;63(5):580-3. doi: 10.1016/j.annemergmed.2013.06.021.
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Keywords: Emergency Department, Quality of Care, Health Services Research (HSR), Quality Improvement, TeamSTEPPS
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Depressive symptoms and hospital readmission in older adults.
The purpose of this study was to quantify the risk of 30-day unplanned hospital readmission in adults aged 65 and older with depressive symptoms. The investigators concluded that, although not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. They asserted that hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Depressive symptoms and hospital readmission in older adults.
J Am Geriatr Soc 2014 Mar;62(3):495-9. doi: 10.1111/jgs.12686..
Keywords: Depression, Elderly, Emergency Department, Hospital Readmissions, Risk
Mitchell SE, Gardiner PM, Sadikova E
Patient activation and 30-day post-discharge hospital utilization.
This study examining the role of patient activation in the rate of hospital readmission within 30 days of discharge found that adult medical patients in an urban academic safety net hospital with lower levels of patient activation had a higher rate of post-discharge 30-day hospital utilization.
AHRQ-funded; HS019771.
Citation: Mitchell SE, Gardiner PM, Sadikova E .
Patient activation and 30-day post-discharge hospital utilization.
J Gen Intern Med. 2014 Feb;29(2):349-55. doi: 10.1007/s11606-013-2647-2..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitalization
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Shapiro JS, Johnson SA, Angiollilo J
Health information exchange improves identification of frequent emergency department users.
The goal of the project was to measure the incremental increase in the number of frequent ED users who were identified when data
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
AHRQ-funded; HS021261.
Citation: Shapiro JS, Johnson SA, Angiollilo J .
Health information exchange improves identification of frequent emergency department users.
Health Aff 2013 Dec;32(12):2193-8. doi: 10.1377/hlthaff.2013.0167..
Keywords: Data, Emergency Department, Healthcare Utilization, Health Information Exchange (HIE), Health Information Technology (HIT)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
Gabayan GZ, Asch SM, Hsia RY
Factors associated with short-term bounce-back admissions after emergency department discharge.
The researchers describe the prevalence, characteristics, and predictors of 7-day bounce-back admissions after ED discharge in a cohort of California hospitals. They found that older white men and patients with a disposition of eloped or having left against medical advice especially at risk for a bounce-back admission. They also found that use of Medicaid or Medicare was associated with higher rates of bounce-back admission.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Asch SM, Hsia RY .
Factors associated with short-term bounce-back admissions after emergency department discharge.
Ann Emerg Med 2013 Aug;62(2):136-44.e1. doi: 10.1016/j.annemergmed.2013.01.017..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions
Easter JS, Haukoos JS, Claud J
Traumatic intracranial injury in intoxicated patients with minor head trauma.
This study to estimate the prevalence of intracranial injury following minor head injury found that 8% of 225 intoxicated patients with minor head injury had clinically important injuries requiring either hospital admission or neurosurgical followup. Neither the Canadian CT Head Rule nor NEXUS criteria had adequate sensitivity to be used with these patients.
AHRQ-funded; HS019464; HS017526
Citation: Easter JS, Haukoos JS, Claud J .
Traumatic intracranial injury in intoxicated patients with minor head trauma.
Acad Emerg Med. 2013 Aug;20(8):753-60. doi: 10.1111/acem.12184..
Keywords: Emergency Department, Trauma, Brain Injury, Shared Decision Making
Shah MN, Morris D, Jones CM
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
The purpose of this study was to document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine-enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. The authors concluded that telemedicine-enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs.
AHRQ-funded; HS018047.
Citation: Shah MN, Morris D, Jones CM .
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
J Am Geriatr Soc 2013 Apr;61(4):571-6. doi: 10.1111/jgs.12157..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Delivery, Long-Term Care
Pines JM, Mutter RL, Zocchi MS
AHRQ Author: Mutter RL
Variation in emergency department admission rates across the United States.
The authors investigated factors related to variation in hospital-level emergency department (ED) admission rates. Using HCUP data, they found that higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates.
AHRQ-authored.
Citation: Pines JM, Mutter RL, Zocchi MS .
Variation in emergency department admission rates across the United States.
Med Care Res Rev 2013 Apr;70(2):218-31. doi: 10.1177/1077558712470565.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Rubinson L, Mutter R, Viboud C
AHRQ Author: Mutter R
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
The authors investigated the impact of the 2009 influenza A(H1N1)pdm09 pandemic on US hospitals. They found that the fall 2009 pandemic period substantially impacted US hospitals, mostly through increased emergency department visits. Furhter, for a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness.
AHRQ-authored.
Citation: Rubinson L, Mutter R, Viboud C .
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
Med Care 2013 Mar;51(3):259-65. doi: 10.1097/MLR.0b013e31827da8ea.
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Keywords: Emergency Department, Emergency Preparedness, Healthcare Cost and Utilization Project (HCUP), Hospitals, Influenza