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
1 to 25 of 33 Research Studies DisplayedGoldberg EM, Trivedi AN, Mor V
Favorable risk selection in Medicare Advantage: trends in mortality and plan exits among nursing home beneficiaries.
This study uses mortality differences, nursing home utilization, and switch rates to assess whether the 2003 Medicare Modernization Act (MMA) successfully decreased risk selection from 2000 to 2012. The study found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Trivedi AN, Mor V .
Favorable risk selection in Medicare Advantage: trends in mortality and plan exits among nursing home beneficiaries.
Med Care Res Rev 2017 Dec;74(6):736-49. doi: 10.1177/1077558716662565..
Keywords: Healthcare Costs, Medicare, Mortality, Nursing Homes
Edwards ST, Peterson K, Chan B
Effectiveness of intensive primary care interventions: a systematic review.
This study systematically reviewed the impact of intensive primary care programs on all-cause mortality, hospitalization, and emergency department use. The authors found that intensive primary care interventions demonstrated varying effectiveness in reducing hospitalizations, and noted there was limited evidence that these interventions were associated with changes in mortality.
AHRQ-funded; HS022981.
Citation: Edwards ST, Peterson K, Chan B .
Effectiveness of intensive primary care interventions: a systematic review.
J Gen Intern Med 2017 Dec;32(12):1377-86. doi: 10.1007/s11606-017-4174-z..
Keywords: Hospitalization, Mortality, Patient-Centered Outcomes Research, Primary Care
Haynes AB, Edmondson LB, Lipsitz SR
Mortality trends after a voluntary checklist-based surgical safety collaborative.
This study sought to determine whether completion of a voluntary, checklist-based surgical quality improvement program is associated with reduced 30-day postoperative mortality. It It found that, despite similar pre-existing rates and trends of postoperative mortality, hospitals in South Carolina completing a voluntary checklist-based surgical quality improvement program had a reduction in deaths after inpatient surgery over the first 3 years of the collaborative compared with other hospitals in the state.
AHRQ-funded; HS019631.
Citation: Haynes AB, Edmondson LB, Lipsitz SR .
Mortality trends after a voluntary checklist-based surgical safety collaborative.
Annals of Surgery 2017 Dec;266(6):923-29. doi: 10.1097/SLA.0000000000002249.
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Keywords: Mortality, Patient Safety, Surgery, Quality Improvement, Quality of Care
Jones JM, Fingar KR, Miller MA
AHRQ Author: Miller MA; Heslin KC
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in in-hospital sepsis mortality rates by race/ethnicity. Mortality rates adjusted for patient characteristics were higher for all minority groups than for white patients. After adjusting for hospital characteristics, sepsis mortality rates in 2013 were similar for white, black, and Hispanic patients.
AHRQ-authored.
Citation: Jones JM, Fingar KR, Miller MA .
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
Crit Care Med 2017 Dec;45(12):e1209-e17. doi: 10.1097/ccm.0000000000002699.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities, Sepsis
Rhee C, Dantes R, Epstein L
Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014.
The researchers estimated the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. In clinical data from 409 hospitals, sepsis was present in 6 percent of adult hospitalizations, and in contrast to claims-based analyses, neither the incidence of sepsis nor the combined outcome of death or discharge to hospice changed significantly between 2009-2014.
AHRQ-funded; HS025008.
Citation: Rhee C, Dantes R, Epstein L .
Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014.
JAMA 2017 Oct 3;318(13):1241-49. doi: 10.1001/jama.2017.13836.
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Keywords: Data, Electronic Health Records (EHRs), Hospitals, Mortality, Sepsis
Xavier Moore J, Donnelly JP, Griffin R
Community characteristics and regional variations in sepsis.
This study aimed to determine the influence of community characteristics upon regional variations in sepsis incidence and case fatality. The study concluded that regional variations in sepsis incidence may be partly explained by community poverty. Other community characteristics do not explain regional variations in sepsis incidence or case fatality.
AHRQ-funded; HS013852.
Citation: Xavier Moore J, Donnelly JP, Griffin R .
Community characteristics and regional variations in sepsis.
Int J Epidemiol 2017 Oct 1;46(5):1607-17. doi: 10.1093/ije/dyx099..
Keywords: Disparities, Low-Income, Mortality, Sepsis, Social Determinants of Health
Platinga LC, King L, Patzer RE
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
The researchers examined the timing of readmissions of hemodialysis patients in the United States and its association with mortality among 285,795 prevalent adult Medicare-primary hemodialysis patients from a national registry. They concluded that regardless of timing, patients with readmissions had a higher risk of death within one year, compared to those with no readmissions.
AHRQ-funded; HS025018.
Citation: Platinga LC, King L, Patzer RE .
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
Kidney Int 2017 Oct;92(4):934-41. doi: 10.1016/j.kint.2017.03.025.
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Keywords: Kidney Disease and Health, Hospital Readmissions, Mortality
Gingrich AA, Bateni SB, Monjazeb AM
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). This study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. The authors concluded that preoperative RT independently predicts higher rates of R0 resection for patients with extremity STS undergoing surgical resection. Negative surgical margins and pre- or postoperative RT are associated with improved OS.
AHRQ-funded; HS022236.
Citation: Gingrich AA, Bateni SB, Monjazeb AM .
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Ann Surg Oncol 2017 Oct;24(11):3252-63. doi: 10.1245/s10434-017-6019-8..
Keywords: Adverse Events, Cancer, Mortality, Patient-Centered Outcomes Research, Patient Safety
Jolley SE, Hough CL, Clermont G
Relationship between race and the effect of fluids on long-term mortality after acute respiratory distress syndrome. secondary analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial.
Short-term follow-up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction. A post hoc analysis of FACTT and the Economic Analysis of Pulmonary Artery Catheters (EAPAC) study was performed. The researchers found that in their cohort, conservative fluid management may have improved 1-year mortality for non-Hispanic black patients with ARDS. However, they found no long-term benefit of conservative fluid management in white subjects.
AHRQ-funded; HS011620.
Citation: Jolley SE, Hough CL, Clermont G .
Relationship between race and the effect of fluids on long-term mortality after acute respiratory distress syndrome. secondary analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial.
Ann Am Thorac Soc 2017 Sep;14(9):1443-49. doi: 10.1513/AnnalsATS.201611-906OC..
Keywords: Racial and Ethnic Minorities, Respiratory Conditions, Mortality
Chatterjee S, Bali V, Carnahan RM
Risk of mortality associated with anticholinergic use in elderly nursing home residents with depression.
The aim of this study was to examine the risk of mortality associated with anticholinergic use among elderly nursing home residents with depression. It found that use of clinically significant anticholinergic medications was associated with a 31 percent increase in risk of mortality among elderly nursing home residents with depression.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Risk of mortality associated with anticholinergic use in elderly nursing home residents with depression.
Drugs Aging 2017 Sep;34(9):691-700. doi: 10.1007/s40266-017-0475-5.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication, Mortality, Nursing Homes
Park JS, Bateni SB, Bold RJ
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
The researchers performed a retrospective analysis of patients with a diagnosis of primary malignant retroperitoneal neoplasm who underwent surgical resection. The modified frailty index (mFI) was calculated according to standard published methods. Their data demonstrate that the majority of patients undergoing retroperitoneal sarcoma resections have few, if any, comorbidities. The mFI was a limited predictor of overall and serious complications and was not a significant predictor of mortality.
AHRQ-funded; HS022236.
Citation: Park JS, Bateni SB, Bold RJ .
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
J Surg Res 2017 Sep;217:191-97. doi: 10.1016/j.jss.2017.05.025.
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Keywords: Cancer, Elderly, Health Status, Mortality, Risk
Leonard CE, Hennessy S, Han X
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
In this review, the authors explore the influence of sulfonylureas on the risk of serious arrhythmias, with specific foci on ischemic preconditioning, cardiac excitability, and serious hypoglycemia as putative mechanisms. They argue that elucidating the relationship between individual sulfonylureas and serious arrhythmias is critical, especially as the diabetes epidemic intensifies and sudden cardiac arrest (SCA) incidence increases in persons with diabetes.
AHRQ-funded; HS023898.
Citation: Leonard CE, Hennessy S, Han X .
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
Trends Endocrinol Metab 2017 Aug;28(8):561-86. doi: 10.1016/j.tem.2017.04.003.
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Keywords: Adverse Drug Events (ADE), Cardiovascular Conditions, Diabetes, Medication, Mortality
Farias AJ, Du XL
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
The purpose of this study was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality. There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
Cancer Epidemiol Biomarkers Prev 2017 Aug;26(8):1266-75. doi: 10.1158/1055-9965.epi-17-0280.
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Keywords: Cancer: Breast Cancer, Disparities, Elderly, Mortality, Racial and Ethnic Minorities
Jensen EA, Lorch SA
Association between off-peak hour birth and neonatal morbidity and mortality among very low birth weight infants.
This study assessed the independent association between overnight or "off-peak" hour delivery and 3 neonatal morbidities strongly associated with childhood neurocognitive impairment. It found that very low birth weight infants born between midnight and 7:00 a.m. are at increased risk for severe intraventricular hemorrhage and death or major neonatal morbidity.
AHRQ-funded; HS015696.
Citation: Jensen EA, Lorch SA .
Association between off-peak hour birth and neonatal morbidity and mortality among very low birth weight infants.
J Pediatr 2017 Jul;186:41-48.e4. doi: 10.1016/j.jpeds.2017.02.007.
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Keywords: Labor and Delivery, Mortality, Newborns/Infants, Adverse Events
Rice WS, Goldfarb SS, Brisendine AE
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
This study explored possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. It concluded that the risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes.
AHRQ-funded; HS013852.
Citation: Rice WS, Goldfarb SS, Brisendine AE .
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
Matern Child Health J 2017 Jul;21(7):1581-88. doi: 10.1007/s10995-017-2290-3.
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Keywords: Disparities, Newborns/Infants, Mortality, Newborns/Infants, Racial and Ethnic Minorities
Moore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Chang SH, Liu X, Carlsson NP
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
The purpose of this study is to identify the range of body mass index (BMI) at liver transplantation (LT) associated with the lowest risks of posttransplant mortality by Model of End Stage Liver Disease (MELD) category. It concluded that obesity in LT patients is not necessarily associated with higher posttransplantation mortality and highlighted the importance of the interaction between BMI and MELD category to determine their survival likelihood.
AHRQ-funded; HS022330.
Citation: Chang SH, Liu X, Carlsson NP .
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
Transplant Direct 2017 Jun 12;3(7):e172. doi: 10.1097/txd.0000000000000681.
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Keywords: Obesity, Transplantation, Mortality, Patient-Centered Outcomes Research, Outcomes
Olfson M, Wall M, Wang S
Service use preceding opioid-related fatality.
The authors analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of non-cancer chronic pain. They found that persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.
AHRQ-funded; HS021112.
Citation: Olfson M, Wall M, Wang S .
Service use preceding opioid-related fatality.
Am J Psychiatry 2017 Jun;175(6):538-44. doi: 10.1176/appi.ajp.2017.17070808.
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Keywords: Chronic Conditions, Opioids, Medicaid, Mortality, Substance Abuse
Travers CP, Carlo WA
How to save 1 million lives in a year in low- and middle-income countries.
This review focuses on educational programs developed to reduce preventable deaths in newborn infants in low- and middle-income countries, including Essential Newborn Care and Helping Babies Breathe, a simplified version of the Neonatal Resuscitation Program. Innovative pragmatic large-scale trials have evaluated these programs in low-resource settings. The results of these studies and the implications for future programs designed to decrease childhood mortality are reviewed.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA .
How to save 1 million lives in a year in low- and middle-income countries.
Neonatology 2017;111(4):431-36. doi: 10.1159/000460512.
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Keywords: Newborns/Infants, Mortality, Newborns/Infants, Pregnancy, Prevention
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Graboyes EM, Kallogjeri D, Saeed MJ
Postoperative care fragmentation and thirty-day unplanned readmissions after head and neck cancer surgery.
Researchers sought to determine the frequency, risk factors, and outcomes for head and neck cancer patients experiencing postdischarge care fragmentation. They found that postdischarge care fragmentation following head and neck cancer surgery is common, as 37 percent of readmitted patients and 31 percent of patients readmitted with a treatment complication are readmitted to a hospital other than the surgical hospital.
AHRQ-funded; HS019455.
Citation: Graboyes EM, Kallogjeri D, Saeed MJ .
Postoperative care fragmentation and thirty-day unplanned readmissions after head and neck cancer surgery.
Laryngoscope 2017 Apr;127(4):868-74. doi: 10.1002/lary.26301.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer, Surgery, Hospital Readmissions, Mortality
Pruitt SL, Laccetti AL, Xuan L
Revisiting a longstanding clinical trial exclusion criterion: impact of prior cancer in early-stage lung cancer.
The researchers examined the prevalence and prognostic impact of a prior cancer diagnosis among patients with early-stage lung cancer. They found no difference in all-cause survival between patients with and without prior cancer. Lung cancer specific survival was improved among patients with prior cancer.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Laccetti AL, Xuan L .
Revisiting a longstanding clinical trial exclusion criterion: impact of prior cancer in early-stage lung cancer.
Br J Cancer 2017 Mar 14;116(6):717-25. doi: 10.1038/bjc.2017.27.
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Keywords: Research Methodologies, Cancer: Lung Cancer, Elderly, Patient-Centered Outcomes Research, Mortality
Valley TS, Walkey AJ, Lindenauer PK
Association between noninvasive ventilation and mortality among older patients with pneumonia.
The researchers aimed to determine the relationship between receipt of noninvasive ventilation and outcomes for patients with pneumonia in a real-world setting. Patients receiving noninvasive ventilation were more likely to be older, male, white, rural-dwelling, and have fewer comorbidities. Among Medicare beneficiaries hospitalized with pneumonia who received mechanical ventilation, noninvasive ventilation use was not associated with a real-world mortality benefit.
AHRQ-funded; HS020672.
Citation: Valley TS, Walkey AJ, Lindenauer PK .
Association between noninvasive ventilation and mortality among older patients with pneumonia.
Crit Care Med 2017 Mar;45(3):e246-e54. doi: 10.1097/ccm.0000000000002076.
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Keywords: Elderly, Mortality, Patient Safety, Outcomes
Brennan MB, Hess TM, Bartle B
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.
Diabetic foot ulcers are associated with an increased risk of death. This study evaluated whether ulcer severity at presentation predicts mortality. It concluded that initial diabetic foot ulcer severity is a more significant predictor of subsequent mortality than coronary artery disease, peripheral arterial disease, or stroke.
AHRQ-funded; HS018542.
Citation: Brennan MB, Hess TM, Bartle B .
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.
J Diabetes Complications. 2017 Mar;31(3):556-561. doi: 10.1016/j.jdiacomp.2016.11.020..
Keywords: Diabetes, Mortality, Chronic Conditions, Pressure Ulcers
McMahon BJ, Bruden D, Townsend-Bulson L
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
The researchers examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic infection. They found those infected with HCV genotype 3 to be at high risk for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
AHRQ-funded; HS000046.
Citation: McMahon BJ, Bruden D, Townsend-Bulson L .
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
Clin Gastroenterol Hepatol 2017 Mar;15(3):431-37.e2. doi: 10.1016/j.cgh.2016.10.012.
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Keywords: Hepatitis, Cancer, Kidney Disease and Health, Risk, Mortality