National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Cancer (1)
- Cardiovascular Conditions (4)
- Care Management (1)
- Children/Adolescents (2)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (1)
- Depression (1)
- Disparities (1)
- Elderly (4)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (6)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Health Insurance (1)
- Heart Disease and Health (3)
- (-) Hospitalization (21)
- Hospital Readmissions (1)
- Hospitals (2)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Labor and Delivery (1)
- Medical Devices (1)
- Medicare (2)
- Medication (2)
- Medication: Safety (1)
- Mortality (3)
- Newborns/Infants (1)
- Nutrition (1)
- Obesity (1)
- Opioids (1)
- Orthopedics (1)
- Outcomes (4)
- Palliative Care (1)
- Patient-Centered Outcomes Research (5)
- Patient Safety (4)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (1)
- Quality Indicators (QIs) (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Rehabilitation (2)
- Risk (5)
- (-) Surgery (21)
- Transitions of Care (1)
- Women (2)
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 21 of 21 Research Studies DisplayedHerzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Pollack LM, Lowder JL, Keller M
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
The objective of this retrospective cohort study was to evaluate whether 30- and 90-day surgical complication and postoperative hospitalization rates after hysterectomy for benign conditions differed by race/ethnicity and whether the differences remained after controlling for patient, hospital, and surgical characteristics. The investigators concluded that Black and Asian/Pacific Islander women had higher risk of some 30- and 90-day surgical complications after hysterectomy than white women. Black and Hispanic women had higher risk of posthysterectomy hospitalization.
AHRQ-funded; HS019455.
Citation: Pollack LM, Lowder JL, Keller M .
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
J Minim Invasive Gynecol 2021 May;28(5):1022-32.e12. doi: 10.1016/j.jmig.2020.12.032..
Keywords: Surgery, Risk, Racial and Ethnic Minorities, Adverse Events, Hospitalization, Women
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Jiramongkolchai P, Lander DP, Kallogjeri D
Trend of surgery for orbital cellulitis: an analysis of state inpatient databases.
This study examined trends in surgery for orbital cellulitis from 2008 to 2015. Retrospective data was extracted from AHRQ’s State Inpatient Databases (SIDs) and patients with an ICD9-CM diagnosis code for orbital cellulitis were identified from Arkansas, Florida, Iowa, Maryland, Nebraska, New York and Wisconsin. The number of hospitalizations declined from a high of 1,574 down to 865 in 2014. The number of surgeries ranged from 103 to 154 from 2008 to 2015. For children, surgery was associated with age, ophthalmologic cormobidity, and conjunctival edema. For adults - male gender, private insurance, optic neuritis, and cranial nervs III/VI/VI palsy were associated with surgery.
AHRQ-funded; HS019455.
Citation: Jiramongkolchai P, Lander DP, Kallogjeri D .
Trend of surgery for orbital cellulitis: an analysis of state inpatient databases.
Laryngoscope 2020 Mar;130(3):567-74. doi: 10.1002/lary.28050..
Keywords: Healthcare Cost and Utilization Project (HCUP), Eye Disease and Health, Surgery, Hospitalization
Kaye DR, Luckenbaugh AN, Oerline M
Understanding the costs associated with surgical care delivery in the Medicare population.
This study’s objective was to quantify the costs of inpatient and outpatient surgery in the Medicare population. Claims data from a 20% national sample of Medicare beneficiaries was used. Results showed that, while spending on inpatient surgery contributed the most to total surgical payments, it declined over the study period, driven by decreases in index hospitalization and readmissions payments. In contrast, spending on outpatient surgery increased across all sites of care (hospital outpatient department, physician office, and ambulatory surgery center). Ophthalmology and hand surgery witnessed the greatest growth in surgical spending over the study period. Surgical care accounts for half of all Medicare spending.
AHRQ-funded; HS024525; HS024728.
Citation: Kaye DR, Luckenbaugh AN, Oerline M .
Understanding the costs associated with surgical care delivery in the Medicare population.
Ann Surg 2020 Jan;271(1):23-28. doi: 10.1097/sla.0000000000003165..
Keywords: Surgery, Healthcare Delivery, Healthcare Costs, Medicare, Elderly, Hospitalization
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Lauerman MH, Herrera AV, Albrecht JS
Interhospital transfers with wide variability in emergency general surgery.
This study examined modern hospital practices for interhospital transfers of emergency general surgery patients. A retrospective review of the Maryland Health Services Cost Review Commission database was conducted from 2013 to 2015. The majority of patients (94.1%) were not transferred with only 3.2% transferred to a hospital and 2.7% transferred from a hospital. For individual hospitals, there was a range of 0-30.5% of encounters transferred to a hospital, 0.02-14.62% transferred from a hospital and 69.25-99.95% not transferred.
AHRQ-funded; HS024560.
Citation: Lauerman MH, Herrera AV, Albrecht JS .
Interhospital transfers with wide variability in emergency general surgery.
Am Surg 2019 Jun;85(6):595-600..
Keywords: Emergency Department, Healthcare Delivery, Hospitalization, Hospitals, Outcomes, Quality of Care, Surgery, Transitions of Care
Hoch JM, Fatusin O, Yenokyan G
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
The purpose of this paper was to identify types of feeding methods following stage 2 palliation and their influence on length of stay. Results showed that feeding methods established at admission for stage 2 palliation are not likely to change by discharge, and that length of stay is more likely to be impacted by tube feeding and intubation history than by age or weight-for-age z score at admission. Recommendations included a better understanding for selection of feeding methods and their impact on patient outcomes in order to develop evidence-based guidelines to decrease variability in clinical practice patterns and to provide appropriate counseling to caregivers.
AHRQ-funded; HS021114.
Citation: Hoch JM, Fatusin O, Yenokyan G .
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
Congenit Heart Dis 2019 May;14(3):438-45. doi: 10.1111/chd.12742.
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Keywords: Nutrition, Newborns/Infants, Children/Adolescents, Hospitalization, Surgery, Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Bateni SB, Gingrich AA, Stewart SL
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
In this study, the investigators sought to compare clinically meaningful outcomes in malignant bowel obstruction (MBO) patients treated with surgical versus medical management using population-based data. In this population-based analysis, medical management was associated with less hospital utilization at 30- and 90-days, fewer in-hospital deaths, and more frequent discharges to home. The authors suggest that these data underscore the potential benefits of medical management for MBO patients at the end-of-life.
AHRQ-funded; HS022236.
Citation: Bateni SB, Gingrich AA, Stewart SL .
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
BMC Cancer 2018 Nov 26;18(1):1166. doi: 10.1186/s12885-018-5108-9..
Keywords: Cancer, Comparative Effectiveness, Hospitalization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Wahl TS, Goss LE, Morris MS
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
The purpose of this study was to investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. The authors hypothesized that ERAS would reduce disparities in pLOS between black and white patients. They concluded that ERAS eliminated racial differences in pLOS between black and white patients undergoing colorectal surgery. Reduced pLOS occurred without increases in mortality, readmissions, and most postoperative complications.
AHRQ-funded; HS013852.
Citation: Wahl TS, Goss LE, Morris MS .
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
Ann Surg 2018 Dec;268(6):1026-35. doi: 10.1097/sla.0000000000002307..
Keywords: Surgery, Racial and Ethnic Minorities, Disparities, Care Management, Healthcare Delivery, Hospitalization, Patient-Centered Outcomes Research, Outcomes
Vogel TR, Smith JB, Kruse RL
Hospital readmissions after elective lower extremity vascular procedures.
This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Factors associated with readmission following lower extremity bypass included heart failure, transfusions, hyponatremia, black race, and bronchodilator use. Risk factors for endovascular readmissions were often chronic conditions including coronary artery disease, kidney disease, hypertension, and hypertensive medications.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Hospital readmissions after elective lower extremity vascular procedures.
Vascular 2018 Jun;26(3):250-61. doi: 10.1177/1708538117728637.
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Keywords: Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk, Surgery
Sun SA, Ma X, Li G
Epidemiologic patterns of in-hospital anaphylaxis in pediatric surgical patients.
This research letter looks into epidemiologic patterns of in-hospital anaphylaxis in pediatric surgical patients. Data from the study came from the Kids’ Inpatient Database (KIDS), which is released every 3 years. The data came from the 2003, 2006, 2009 and 2012 KID data sets. Children were included if they had a surgical admission for anaphylaxis which is interpreted as an in-hospital event. Overall in-hospital mortality for all children was 0.38% but for in-hospital anaphylaxis was 2.47%. The most common reason children were in the hospital before the event was hematological and myeloproliferative disorders, with the largest percentage undergoing bone marrow transplant procedures. Although the exact cause of the reaction was not known, hypersensitivity to chemotherapeutic agents and more recent mAb treatments have been identified as reasons for the in-hospital anaphylaxis.
AHRQ-funded; HS022941.
Citation: Sun SA, Ma X, Li G .
Epidemiologic patterns of in-hospital anaphylaxis in pediatric surgical patients.
J Allergy Clin Immunol 2018 May;141(5):1904-05.e2. doi: 10.1016/j.jaci.2017.11.030..
Keywords: Adverse Events, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Hospitals, Inpatient Care, Practice Patterns, Surgery
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Saeed MJ, Turner TE, Brown DL
Trends in inferior vena cava filter placement by indication in the United States from 2005 to 2014.
This study examined trends in inpatient inferior vena cava (IVC) filter placement overall and by indication from 2005 to 2014. The IVC filter placement rate per 100 000 hospitalizations increased from 322.1 (n = 99 779) in 2005 to 412.0 (n = 129 026) in 2010, decreased to 374.1 (n = 117 731) in 2011, and continued declining to 321.8 (n = 95 735) in 2014. The percentage of prophylactic IVC filter placement decreased from 28.9 percent in 2005 to 22.6 percent in 2014.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Turner TE, Brown DL .
Trends in inferior vena cava filter placement by indication in the United States from 2005 to 2014.
JAMA Intern Med 2017 Dec;177(12):1861-62. doi: 10.1001/jamainternmed.2017.5960.
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Keywords: Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Surgery
Moghavem N, McDonald K, Ratliff JK
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
The researchers sought to determine how Patient Safety Indicator (PSI) rates and their impact on other outcomes in patients undergoing cranial neurosurgery compared with other surgeries.. They found that procedure indication was strongly associated with PSI development. The neurosurgical population had significantly higher risk-adjusted ratios of most PSIs evaluated compared with other surgical patients. Development of a PSI was strongly associated with increased length of stay and hospital cost.
AHRQ-funded; HS018558.
Citation: Moghavem N, McDonald K, Ratliff JK .
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
Med Care 2016 Apr;54(4):359-64. doi: 10.1097/mlr.0000000000000490.
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Keywords: Quality Indicators (QIs), Surgery, Hospitalization, Outcomes, Quality of Care
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Riall TS, Adhikari D, Parmar AD
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
For older patients with newly diagnosed symptomatic gallstones, researchers calculated their 2-year risk of emergent gallstone-related hospitalization. They found that patients in the high-risk group were less likely to receive elective cholecystectomy than those in the low-risk group. The study used Texas Medicare data for 161,568 patients with an episode of symptomatic gallstones.
AHRQ-funded; HS022134
Citation: Riall TS, Adhikari D, Parmar AD .
The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications.
J Am Coll Surg. 2015 Apr;220(4):682-90. doi: 10.1016/j.jamcollsurg.2014.12.012..
Keywords: Hospitalization, Elderly, Medicare, Surgery
King JT, Perkal MF, Rosenthal RA
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
The researchers explored the current relationship between perioperative mortality and indicators of immune function, anemia, and hypoalbuminemia among HIV-infected and uninfected individuals. Among HIV-infected patients receiving antiretroviral therapy, modern postoperative mortality rates are low and lower CD4 cell counts are associated with increased mortality, but characteristics other than HIV status, such as age and hypoalbuminemia, are also important determinants of outcome.
AHRQ-funded; HS021112.
Citation: King JT, Perkal MF, Rosenthal RA .
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
JAMA Surg 2015 Apr;150(4):343-51. doi: 10.1001/jamasurg.2014.2257..
Keywords: Healthcare Cost and Utilization Project (HCUP), Mortality, Human Immunodeficiency Virus (HIV), Hospitalization, Surgery
Abdelsattar ZM, Krapohl G, Alrahmani L
Postoperative burden of hospital-acquired Clostridium difficile infection.
This study of 35,363 surgical patients found that 0.51 percent developed a clostridium difficile infection (CDI), with the highest rates occurring after lower-extremity amputation, bowel resection or repair, and gastric or esophageal operations. Post-operative CDI was also associated with higher rates of extended length of stay, emergency room presentations, and readmissions.
AHRQ-funded; HS000053
Citation: Abdelsattar ZM, Krapohl G, Alrahmani L .
Postoperative burden of hospital-acquired Clostridium difficile infection.
Infect Control Hosp Epidemiol. 2015 Jan;36(1):40-6. doi: 10.1017/ice.2014.8..
Keywords: Clostridium difficile Infections, Patient Safety, Surgery, Hospitalization
Aterburn D, Powers JD, Toh S
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
A retrospective study of 7,457 patients undergoing laparoscopic bariatric surgery found that patients receiving gastric bypass experienced much greater weight loss than those receiving gastric banding but they had a higher risk of short-term complications and long-term subsequent hospitalizations. However, gastric bypass patients had a lower risk of long-term subsequent intervention procedures than did gastric banding patients.
AHRQ-funded; HS019912
Citation: Aterburn D, Powers JD, Toh S .
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
JAMA Surg. 2014 Dec;149(12):1279-87. doi: 10.1001/jamasurg.2014.1674..
Keywords: Obesity, Surgery, Adverse Events, Patient Safety, Hospitalization
Owens PL, Barrett ML, Raetzman S
AHRQ Author: Owens PL, Steiner CA
Surgical site infections following ambulatory surgery procedures.
The authors determined the incidence of clinically significant surgical site infections (CS-SSIs) following low- to moderate-risk ambulatory surgery in patients with low risk for surgical complications. They found that among patients in 8 states undergoing ambulatory surgery, rates of postsurgical visits for CS-SSIs were low relative to all causes but may represent a substantial number of adverse outcomes in aggregate, thus meriting quality improvement efforts to minimize their occurrence.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Owens PL, Barrett ML, Raetzman S .
Surgical site infections following ambulatory surgery procedures.
JAMA 2014 Feb 19;311(7):709-16. doi: 10.1001/jama.2014.4.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Injuries and Wounds, Ambulatory Care and Surgery, Surgery, Hospitalization, Patient Safety, Adverse Events