National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Access to Care (1)
- Adverse Drug Events (ADE) (1)
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- (-) Behavioral Health (7)
- Comparative Effectiveness (1)
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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 7 of 7 Research Studies DisplayedOrth J, Li Y, Simning A
Severe behavioral health manifestations in nursing homes: associations with service availability?
The objective of this study was to examine associations between availability of behavioral health (BH) services and the presence of severe depression, suicidal ideation (SI), and severe aggressive behaviors (ABs) among nursing home (NH) residents. 2017 survey data on BH service availability was obtained from 1,051 NHs and the Minimum Data Set (MDS) to identify long-term stay residents in these facilities (n = 101,238). Odds of severe depression were 21% higher when NHs reported inadequate BH staff education as well as 13% higher for SI and 10% higher for severe ABs among residents in facilities reporting inadequate facility infrastructure. Facility-level factors such as staffing, training, and turnover were also statistically significant associations with these severe BH manifestations.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Severe behavioral health manifestations in nursing homes: associations with service availability?
J Am Geriatr Soc 2020 Nov;68(11):2643-49. doi: 10.1111/jgs.16772..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Access to Care
Germack HD, Bizhanova Z, Roberts ET
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
This study’s purpose was to examine the variation across hospitals in readmissions for patients with serious mental illness (SMI) and differences in the characteristics of hospitals with the highest and lowest readmission rates. A cross-sectional analysis was conducted of pooled inpatient claims from 2013-2016. The 5% sample of fee-for-service Medicare beneficiaries included patients with SMI. The authors identified 2066 hospitals with at least 30 index admissions for Medicare beneficiaries with SMI. Factors most strongly associated with increased risk of readmission included substance use disorder and end stage renal disease. Hospital readmission rates ranged from 7.05% to 15.24%. Hospitals with the lowest adjusted readmission rates were more likely to be teaching hospitals and located in the South or Midwest.
AHRQ-funded; HS026727.
Citation: Germack HD, Bizhanova Z, Roberts ET .
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
Healthc 2020 Sep;8(3):100453. doi: 10.1016/j.hjdsi.2020.100453..
Keywords: Elderly, Behavioral Health, Hospital Readmissions, Medicare, Hospitals, Hospitalization
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Rhee TG, Olfson M, Sint K
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
Electroconvulsive therapy (ECT) is an important therapy for treatment-resistant depression and is especially effective for elderly individuals with depression. This study provides the first US nationally representative description of ECT in the elderly. The investigators concluded that despite substantial evidence of efficacy, ECT use remained rare among elderly patients with depression.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Sint K .
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
J Clin Psychiatry 2020 Jul 7;81(4). doi: 10.4088/JCP.19m13186.
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Keywords: Elderly, Medicare, Depression, Behavioral Health, Treatments, Patient-Centered Outcomes Research
Schmutte TJ, Wilkinson ST
Suicide in older adults with and without known mental illness: results from the National Violent Death Reporting System, 2003-2016.
Suicide risk increases with age, and evidence exists for the underdiagnosis and undertreatment of suicide risk in older adults. Recent data suggest that many U.S. adults who die from suicide do not have a known mental health condition. This study compared the characteristics and precipitating circumstances of geriatric suicide decedents with and without known mental illnesses.
AHRQ-funded; HS023000.
Citation: Schmutte TJ, Wilkinson ST .
Suicide in older adults with and without known mental illness: results from the National Violent Death Reporting System, 2003-2016.
Am J Prev Med 2020 Apr;58(4):584-90. doi: 10.1016/j.amepre.2019.11.001..
Keywords: Elderly, Behavioral Health
Chatterjee S, Bali V, Carnahan RM
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
This study evaluated whether elderly nursing home residents with mild depression and intact cognition experienced cognitive impairment after using anticholinergic drugs. The study was a population-based nested case-control study using Minimum Data Set (MDS)-linked Medicare data where the base cohort were patients 65 years and older with depression who had intact cognition. Cumulative anticholinergic burden was measured within 30, 60, and 90 days preceding the event (cognitive measurement) date using the Anticholinergic Drug Scale (ADS). The end sample compared 3707 cases with mild-to-moderate cognition to 3707 matched controls with intact cognition. There was no association with cumulative anticholinergic exposure at 30 days with cognitive impairment, but the odds of cognitive impairment increased with exposure 60 and 90 days before the event date. This study concludes there should be concern in using anticholinergic drugs for longer than 30 days with elderly nursing home residents.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression.
Res Social Adm Pharm 2020 Mar;16(3):329-35. doi: 10.1016/j.sapharm.2019.05.020..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Medication, Neurological Disorders, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice