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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
26 to 50 of 145 Research Studies DisplayedHirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
Fish-Trotter H, Collins SP, Danagoulian S
Design and rationale of a randomized trial: using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF).
The evidence for existing acute heart failure (AHF) therapies are poor; currently used AHF treatment do not reliably improve long-term outcomes and emergency department treatment has changed little in 40 years. The authors of this article propose a robust clinical effectiveness trial to demonstrate the effectiveness of short-stay units for the management of AHF for lower-risk patients.
AHRQ-funded; HS025411.
Citation: Fish-Trotter H, Collins SP, Danagoulian S .
Design and rationale of a randomized trial: using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF).
Contemp Clin Trials 2018 Sep;72:137-45. doi: 10.1016/j.cct.2018.08.003..
Keywords: Patient-Centered Healthcare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Outcomes, Hospitalization
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
This retrospective cohort study investigated the association of coexistent obstructive sleep apnoea with acute severity markers (i.e. invasive positive pressure ventilation use and hospital length of stay) among adults hospitalised for acute exacerbation of chronic obstructive pulmonary disease.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
Intern Med J 2018 Sep;48(9):1150-53. doi: 10.1111/imj.14016..
Keywords: Respiratory Conditions, Hospitalization, Sleep Problems, Chronic Conditions
Donato KM, Leon-Perez G, Wallston KA
Something old, something new: when gender matters in the relationship between social support and health.
This paper investigated how social support differentially benefitted self-rated health among men and women hospitalized with heart disease. They found that gender differentiated the effect of nonmarital family contact on health but only when heart disease was newly diagnosed. When newly diagnosed, more frequent contact with family was associated with better self-rated health for women but not men.
AHRQ-funded; HS024898.
Citation: Donato KM, Leon-Perez G, Wallston KA .
Something old, something new: when gender matters in the relationship between social support and health.
J Health Soc Behav 2018 Sep;59(3):352-70. doi: 10.1177/0022146518789362..
Keywords: Cardiovascular Conditions, Hospitalization, Sex Factors
Blecker S, Herrin J, Kwon JY
Effect of hospital readmission reduction on patients at low, medium, and high risk of readmission in the Medicare population.
This study examined the effect of hospital readmission reduction on patients at low, medium, and high risk of readmission in Medicare beneficiaries. The researchers theorized that the hospitals could be filled with more high-risk patients. National data from January 2009 to June 2015 was used to examine 5 specialty cohorts. The readmission rate was 16.2% for unplanned readmission within 30 days. There was a higher risk of readmission for surgery/gynecology and neurology cohorts but no significant increase in predicted risk for hospitalizations in medicine, cardiovascular, or cardiorespiratory cohorts.
AHRQ-funded; HS023683; HS022882.
Citation: Blecker S, Herrin J, Kwon JY .
Effect of hospital readmission reduction on patients at low, medium, and high risk of readmission in the Medicare population.
J Hosp Med 2018 Aug;13(8):537-43. doi: 10.12788/jhm.2936..
Keywords: Hospital Readmissions, Medicare, Hospitals, Elderly, Hospitalization
Lin MY, Kressin NR, Paasche-Orlow MK
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
This study’s objective was to verify other studies that showed that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition was lower among blacks than whites. Inpatient discharge and vital status data was used for patients 18 and older hospitalized in California from January 2010 to June 30, 2011 for a variety of acute conditions. Their analysis verified lower risk of mortality among blacks. Factors for this may be associated with a higher rate of hospitalization with an 80% risk and inpatient mortality was also 30% higher with whites than blacks.
AHRQ-funded; HS022242.
Citation: Lin MY, Kressin NR, Paasche-Orlow MK .
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
Med Care 2018 Aug;56(8):665-72. doi: 10.1097/mlr.0000000000000938..
Keywords: Hospitalization, Mortality, Racial and Ethnic Minorities
Henke RM, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Medicare Advantage and traditional Medicare hospitalization intensity and readmissions.
This study uses 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. The authors found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicare Advantage and traditional Medicare hospitalization intensity and readmissions.
Med Care Res Rev 2018 Aug;75(4):434-53. doi: 10.1177/1077558717692103..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Readmissions, Hospitalization, Medicare
Goto T, Faridi MK, Camargo CA
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
The purpose of this study was to investigate the longitudinal changes in principal readmission diagnoses within 30 days after hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The investigators found that the proportions of principal discharge diagnosis of readmission changed significantly at around postdischarge day 7.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Camargo CA .
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
Med Care 2018 Aug;56(8):673-78. doi: 10.1097/mlr.0000000000000940..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization
Plantinga LC, Masud T, Lea JP
Post-hospitalization dialysis facility processes of care and hospital readmissions among hemodialysis patients: a retrospective cohort study.
This study examined the association of post-hospitalization processes of care at hemodialysis facilities with pulmonary edema-related and other readmissions. The study results suggested that some interventions performed at the dialysis facility in the post-hospitalization period may be associated with reduced readmission risk, while others may provide a potential existing means of identifying patients at higher risk for readmissions, to whom such interventions could be efficiently targeted.
AHRQ-funded; HS025018.
Citation: Plantinga LC, Masud T, Lea JP .
Post-hospitalization dialysis facility processes of care and hospital readmissions among hemodialysis patients: a retrospective cohort study.
BMC Nephrol 2018 Jul 31;19(1):186. doi: 10.1186/s12882-018-0983-5..
Keywords: Kidney Disease and Health, Hospital Readmissions, Hospitalization
Holmgren AJ, Adler-Milstein J, Chen LM
Participation in a voluntary bundled payment program by organizations providing care after an acute hospitalization
This research letter addresses spending on post–acute care (PAC), or care provided after a stay in an acute care hospital. PAC is the largest driver of variation in total per capita Medicare spending. To address this, Medicare has targeted PAC spending in payment reforms including voluntary bundled payment programs. This letter discusses participation in these voluntary payment programs.
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AHRQ-funded; HS024698
Citation: Holmgren AJ, Adler-Milstein J, Chen LM .
Participation in a voluntary bundled payment program by organizations providing care after an acute hospitalization
JAMA 2018 Jul 24;320(4):402-04. doi: 10.1001/jama.2018.8666..
Keywords: Payment, Health Services Research (HSR), Health Services Research (HSR), Hospitalization, Medicare
Plantinga LC, King LM, Masud T
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Pulmonary edema is prevalent and may be a common cause of hospital readmissions in hemodialysis patients. In this retrospective cohort study, the investigators aimed to estimate the national burden of, and identify correlates of, readmissions related to pulmonary edema among hemodialysis patients. The investigators concluded that readmissions related to pulmonary edema were common in hemodialysis patients. They suggest that interventions aimed at preventing such readmissions could have a substantial impact on readmissions overall, particularly targeted at incident hemodialysis patients with a prior history of heart failure and patients initially admitted for pulmonary edema.
AHRQ-funded; HS025018.
Citation: Plantinga LC, King LM, Masud T .
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Nephrol Dial Transplant 2018 Jul;33(7):1215-23. doi: 10.1093/ndt/gfx335..
Keywords: Adverse Events, Dialysis, Heart Disease and Health, Hospital Readmissions, Hospitalization, Kidney Disease and Health
Leyenaar JK, Shieh MS, Lagu T
Hospital and community characteristics associated with pediatric direct admission to hospital.
Researchers aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and to evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates. Using HCUP data, they found that direct admission rates were associated with several hospital and community characteristics, but the majority of variation in hospitals' direct admission rates was not explained by these factors. They recommended that their findings suggest opportunities for diverse hospital types to develop the infrastructure and communication systems necessary to support pediatric direct admissions.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Shieh MS, Lagu T .
Hospital and community characteristics associated with pediatric direct admission to hospital.
Acad Pediatr 2018 Jul;18(5):525-34. doi: 10.1016/j.acap.2017.10.002..
Keywords: Children/Adolescents, Hospitalization, Healthcare Cost and Utilization Project (HCUP), Hospitals
Doupnik SK, Lawlor J, Zima BT
Mental health conditions and unplanned hospital readmissions in children.
Mental health conditions (MHCs) are prevalent among hospitalized children and could influence the success of hospital discharge. The objective of this retrospective cross-sectional study was to assess the relationship between MHCs and 30-day readmissions. The investigators concluded that MHCs were associated with a higher likelihood of hospital readmission in children admitted for medical conditions and procedures. They suggest that understanding the influence of MHCs on readmissions could guide strategic planning to reduce unplanned readmissions for children with co-occurring physical and mental health conditions.
AHRQ-funded; HS023292.
Citation: Doupnik SK, Lawlor J, Zima BT .
Mental health conditions and unplanned hospital readmissions in children.
J Hosp Med 2018 Jul;13(7):445-52. doi: 10.12788/jhm.2910..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Readmissions, Hospitalization, Risk, Young Adults
Stevens JP, Dechen T, Schwartzstein R
Prevalence of dyspnea among hospitalized patients at the time of admission.
Dyspnea is an uncomfortable and distressing sensation experienced by hospitalized patients. There is no large-scale study of the prevalence and intensity of patient-reported dyspnea at the time of admission to the hospital. In this study the investigators conducted a prospective cohort study among all consecutive hospitalized patients at a single tertiary care center in Boston, MA. The investigators concluded that dyspnea is a common symptom among all hospitalized patients and that routine documentation of dyspnea is feasible in a large tertiary care center.
AHRQ-funded; HS024288.
Citation: Stevens JP, Dechen T, Schwartzstein R .
Prevalence of dyspnea among hospitalized patients at the time of admission.
J Pain Symptom Manage 2018 Jul;56(1):15-22.e2. doi: 10.1016/j.jpainsymman.2018.02.013..
Keywords: Emergency Department, Hospitalization, Pain
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Leyenaar JK, Shevenell M, Rizzo PA
Multi-stakeholder informed guidelines for direct admission of children to hospital.
The purpose of this study is to develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. The investigators concluded that these direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Shevenell M, Rizzo PA .
Multi-stakeholder informed guidelines for direct admission of children to hospital.
J Pediatr 2018 Jul;198:273-78.e7. doi: 10.1016/j.jpeds.2018.03.007..
Keywords: Children/Adolescents, Guidelines, Hospitalization, Hospitals, Patient Safety
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Pickens G, Karaca Z, Cutler E
AHRQ Author: Karaca Z, Wong HS
Changes in hospital inpatient utilization following health care reform.
The purpose of this retrospective study was to estimate the effects of 2014 Medicaid expansions on inpatient outcomes using population and unemployment data from HCUP’s State Inpatient Databases. Outcomes included total admissions, referral-sensitive surgical and preventable admissions, length of stay, cost, and severity of patient illness. The authors conclude that Medicaid expansions did not change all-payer admission volumes, but expansions were associated with increased Medicaid and decreased uninsured volumes. The results of the study suggest that previously uninsured persons with a greater need for inpatient services were the most likely to gain coverage.
AHRQ-authored; AHRQ-funded.
Citation: Pickens G, Karaca Z, Cutler E .
Changes in hospital inpatient utilization following health care reform.
Health Serv Res 2018 Jun 30;53(4):2446-69. doi: 10.1111/1475-6773.12734..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Inpatient Care, Medicaid, Policy
Graham KL, Auerbac AD, Schnipper JL
Preventability of early versus late hospital readmissions in a national cohort of general medicine patients.
The purpose of this study was to determine whether readmissions within 7 days of discharge differed from those between 8 and 30 days after discharge with respect to preventability. The investigators found that early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions.
AHRQ-funded; HS022241.
Citation: Graham KL, Auerbac AD, Schnipper JL .
Preventability of early versus late hospital readmissions in a national cohort of general medicine patients.
Ann Intern Med 2018 Jun 5;168(11):766-74. doi: 10.7326/m17-1724..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitals, Hospitalization, Prevention
Bell SA, Abir M, Choi H
All-cause hospital admissions among older adults after a natural disaster.
The researchers characterized hospital admissions among older adults for any cause in the 30 days after a significant natural disaster in the United States. They found a significant increase in all-cause hospitalizations following the tornadoes of April 27, 2011. No increase in ICU admissions or inhospital mortality were associated with the natural disaster.
AHRQ-funded; HS020672.
Citation: Bell SA, Abir M, Choi H .
All-cause hospital admissions among older adults after a natural disaster.
Ann Emerg Med 2018 Jun;71(6):746-54.e2. doi: 10.1016/j.annemergmed.2017.06.042..
Keywords: Elderly, Hospitalization
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
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
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Mandatory physician reporting of at-risk drivers: the older driver example.
The hypothesis that mandatory physician reporting laws reduce the rate of crash-related hospitalizations among older adult drivers was tested. Mandatory physician reporting failed to explain any significant variation in crash hospitalization rates, when adjusting for other state-specific laws and characteristics. Vision testing at in-person license renewal was a significant predictor of lower crash hospitalization rate.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Mandatory physician reporting of at-risk drivers: the older driver example.
Gerontologist 2018 May 8;58(3):578-87. doi: 10.1093/geront/gnw209.
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Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Injuries and Wounds
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
Parikh K, Keller S, Ralston S
Inpatient quality improvement interventions for asthma: a meta-analysis.
This article reviewed interventional studies of inpatient-initiated asthma quality improvement (QI) to synthesize its impact on health care utilization. Thirty articles were included; 12 provided data on health care reutilization outcomes. The selected studies were categorized by intervention type and outcome. Risk ratios for readmissions were examined and a subanalyis of multimodal interventions conducted; the latter suggested lower readmission rates. A subanalysis of education and discharge planning interventions did not show an effect. The authors did not identify any inpatient strategies that impacted health care reutilization within 30 days of index hospitalization, but note that multimodal interventions demonstrated impact over the longer interval.
AHRQ-funded; HS024554.
Citation: Parikh K, Keller S, Ralston S .
Inpatient quality improvement interventions for asthma: a meta-analysis.
Pediatrics 2018 May;141(5). doi: 10.1542/peds.2017-3334.
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Keywords: Asthma, Children/Adolescents, Hospitalization, Inpatient Care, Quality Improvement