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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
76 to 100 of 145 Research Studies DisplayedStone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Ryskina KL, Konetzka RT, Werner RM
Association between 5-Star nursing home report card ratings and potentially preventable hospitalizations.
The goal of this study was to test whether the improvements in nursing homes’ 5-star ratings were correlated with reductions in rates of hospitalization; the researchers’ hypothesis was that increased attention to ratings motivated nursing homes to make changes to improve ratings but did not affect hospitalization rate, resulting in a weakened association between ratings and hospitalizations. 2007-2010 Medicare hospital claims and nursing home clinical assessment data were used to compare the correlation between nursing homes’ ratings and hospitalization rates. Correlation weakened slightly after the ratings became publicly available. The researchers conclude that improvements in nursing home ratings after the release of Medicare's 5-star rating system were not accompanied by improvements in a broader measure of outcomes for post-acute care patients and, although this dissociation may be due to additional factors, the 5-star ratings became less meaningful as an indicator of nursing home quality for these patients.
AHRQ-funded; HS021861.
Citation: Ryskina KL, Konetzka RT, Werner RM .
Association between 5-Star nursing home report card ratings and potentially preventable hospitalizations.
Inquiry 2018 Jan-Dec;55:46958018787323. doi: 10.1177/0046958018787323..
Keywords: Elderly, Nursing Homes, Medicare, Quality Indicators (QIs), Provider Performance, Quality Measures, Hospitalization, Quality of Care
Rinehart DJ, Oronce C, Durfee MJ
Identifying subgroups of adult superutilizers in an urban safety-net system using latent class analysis: implications for clinical practice.
The objective of the study was to identify clinically distinct subgroups of adult superutilizers. The overall cohort had high rates of multiple chronic medical conditions, mental health and substance use disorders, and homelessness. However, the patterns of these conditions were different between subgroups, providing important information for tailoring interventions.
AHRQ-funded; HS023901.
Citation: Rinehart DJ, Oronce C, Durfee MJ .
Identifying subgroups of adult superutilizers in an urban safety-net system using latent class analysis: implications for clinical practice.
Med Care 2018 Jan;56(1):e1-e9. doi: 10.1097/mlr.0000000000000628.
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Keywords: Healthcare Utilization, Hospitalization, Urban Health, Rural/Inner-City Residents
DeWaters AL, Chansard M, Anzueto A
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in veterans hospitalized with pneumonia. It found that patients with untreated depression had a significantly higher 30-day and 90-day mortality, as well as significantly higher intensive care unit admission rates, compared to patients with treated depression.
AHRQ-funded; HS022418.
Citation: DeWaters AL, Chansard M, Anzueto A .
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
Am J Med Sci 2018 Jan;355(1):21-26. doi: 10.1016/j.amjms.2017.08.015.
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Keywords: Depression, Hospitalization, Patient-Centered Outcomes Research, Pneumonia
Chen R, Strait KM, Dharmarajan K
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
This study investigates how contemporary hospitals use this resource-intensive setting of intensive care units (ICUs) and whether higher use is associated with better outcomes. It found that rates of ICU admission for patients with AMI vary substantially across hospitals and were not associated with differences in mortality, but were associated with greater use of critical care therapies.
AHRQ-funded; HS020672.
Citation: Chen R, Strait KM, Dharmarajan K .
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
Am Heart J 2015 Dec;170(6):1161-9. doi: 10.1016/j.ahj.2015.09.003.
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Keywords: Hospitalization, Intensive Care Unit (ICU), Heart Disease and Health
Lee GE, Fisher BT, Xiao R
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
The researchers investigated the rate of influenza hospitalizations and attributable mortality in children with cancer. They concluded that the burden of influenza-related hospitalizations in children with acute lymphoblastic leukemia is high and associated with significantly increased resource utilization and attributable mortality.
AHRQ-funded; HS020939.
Citation: Lee GE, Fisher BT, Xiao R .
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
J Pediatric Infect Dis Soc 2015 Dec;4(4):290-6. doi: 10.1093/jpids/piu066..
Keywords: Children/Adolescents, Hospitalization, Influenza, Mortality, Children/Adolescents
Ericson JE, Popoola VO, Smith PB
Burden of invasive staphylococcus aureus infections in hospitalized infants.
This study compared demographics and mortality of inf ants with invasive methicillin-resistant S aureus (MRSA) and methicillin-susceptible S aureus (MSSA), to determine the annual proportion of S aureus infections that were MRSA. It found that infant mortality after invasive MRSA and MSSA infections was similar, but MSSA caused more infections and more deaths in infants than MRSA.
AHRQ-funded; HS022872.
Citation: Ericson JE, Popoola VO, Smith PB .
Burden of invasive staphylococcus aureus infections in hospitalized infants.
JAMA Pediatr 2015 Dec;169(12):1105-11. doi: 10.1001/jamapediatrics.2015.2380..
Keywords: Newborns/Infants, Methicillin-Resistant Staphylococcus aureus (MRSA), Mortality, Hospitalization, Risk
Warnock DG, Powell TC, Donnelly JP
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
The objective of this study was to categorize hospital-associated acute kidney injury (HA-AKI) based on the timing of minimum and peak inpatient serum creatinine (sCr) and describe the association with inpatient mortality. It concluded that risk of short-term inpatient mortality is associated with AKI, and this risk is attenuated with recovery of kidney function in the hospital.
AHRQ-funded; HS013852.
Citation: Warnock DG, Powell TC, Donnelly JP .
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
Nephron 2015;131(4):227-36. doi: 10.1159/000441956.
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Keywords: Kidney Disease and Health, Adverse Events, Hospitalization, Mortality
Stockmann C, Ampofo K, Pavia AT
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
This study compared outcomes between oral therapy and (outpatient parenteral antibiotic therapy (OPAT) for pediatric parapneumonic empyema (PPE) . The frequency of complications was similar with oral therapy and OPAT for children with PPE. Oral antibiotics may be considered safe and effective for children with PPE who will be discharged to complete therapy in the outpatient setting.
AHRQ-funded; HS023320.
Citation: Stockmann C, Ampofo K, Pavia AT .
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
Hosp Pediatr 2015 Dec;5(12):605-12. doi: 10.1542/hpeds.2015-0100.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Medication, Hospitalization, Children/Adolescents
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
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
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Gabayan GZ, Derose SF, Chiu VY
Emergency department crowding and outcomes after emergency department discharge.
The researchers assess whether a panel of emergency department (ED) crowding measures, including 2 reported by the Centers for Medicare & Medicaid Services (CMS), is associated with inpatient admission and death within 7 days of ED discharge. Their findings suggest that ED length of stay is a proxy for unmeasured differences in case mix and challenge the validity of the CMS metric as a safety measure for discharged patients.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Derose SF, Chiu VY .
Emergency department crowding and outcomes after emergency department discharge.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospital Discharge, Outcomes, Hospitalization
Ananth P, Melvin P, Feudtner C
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
The researchers assessed hospital resource use in children by type and number of life-threatening complex chronic conditions (LT-CCCs). They found that hospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/ immunologic or multiple conditions have the greatest hospital use.
AHRQ-funded; HS023092.
Citation: Ananth P, Melvin P, Feudtner C .
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
Pediatrics 2015 Nov;136(5):938-46. doi: 10.1542/peds.2015-0260..
Keywords: Chronic Conditions, Children/Adolescents, Hospitalization, Palliative Care
Olfson M, Wang S, Blanco C
National trends in hospital-treated self-harm events among middle-aged adults.
This study assessed national trends in hospital-treated self-harm events focusing on adults aged 45-64years. Between 2001 and 2011, there was a disproportionate national increase in hospital-treated self-harm events among middle-aged adults that mirrored national trends in suicide. The increase was largely accounted for by an overall increase in mental health hospitalizations of middle-aged adults.
AHRQ-funded; HS021112.
Citation: Olfson M, Wang S, Blanco C .
National trends in hospital-treated self-harm events among middle-aged adults.
Gen Hosp Psychiatry 2015 Nov-Dec;37(6):613-9. doi: 10.1016/j.genhosppsych.2015.08.004.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Behavioral Health, Hospitalization
Sentell T, Miyamura J, Ahn HJ
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
The authors studied congestive heart failure (CHF) hospitalizations among racial groups. They found that high preventable CHF hospitalization rates are seen in some Asian and Pacific Islander groups, especially Native Hawaiians and Filipinos, who have these hospitalizations at younger ages than other studied groups.
AHRQ-funded; HS019990.
Citation: Sentell T, Miyamura J, Ahn HJ .
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
J Immigr Minor Health 2015 Oct;17(5):1289-97. doi: 10.1007/s10903-014-0098-4.
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Keywords: Heart Disease and Health, Hospitalization, Prevention, Racial and Ethnic Minorities, Social Determinants of Health
Carls GS, Henke RM, Karaca Z
AHRQ Author: Karaca Z, Wong HS
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
The researchers assessed the association between unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995–2011. They found that for both adults and seniors, a 1 percent increase in the unemployment rate was associated with a statistically significant decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Carls GS, Henke RM, Karaca Z .
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
Health Serv Res 2015 Oct;50(5):1688-709. doi: 10.1111/1475-6773.12298..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Healthcare Utilization, Hospitalization
Valley TS, Sjoding MW, Ryan AM
Association of intensive care unit admission with mortality among older patients with pneumonia.
The purpose of this study was to estimate the relationship between ICU admission and outcomes for elderly patients with pneumonia. It concluded that among Medicare beneficiaries hospitalized with pneumonia, ICU admission of patients for whom the decision appeared to be discretionary was associated with improved survival and no significant difference in costs.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Association of intensive care unit admission with mortality among older patients with pneumonia.
JAMA 2015 Sep 22-29;314(12):1272-9. doi: 10.1001/jama.2015.11068..
Keywords: Patient Safety, Intensive Care Unit (ICU), Elderly, Mortality, Hospitalization
Teshome BF, Lee GC, Reveles KR
Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.
The study objective was to assess the effect of initial MRSA therapy on mortality in community–onset (CO) pneumonia patients that a new MRSA prediction score had classified into low, medium, and high-risk groups based on objective criteria available at baseline. The study demonstrated improved survival with initial MRSA therapy in the 2 percent of CO-pneumonia patients classified as high-risk.
AHRQ-funded; HS022418.
Citation: Teshome BF, Lee GC, Reveles KR .
Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.
BMC Infect Dis 2015 Sep 18;15:380. doi: 10.1186/s12879-015-1119-1..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Risk, Patient-Centered Outcomes Research, Hospitalization
Heo HH, Sentell TL, Li D
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
The researchers compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. They found that older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care.
AHRQ-funded; HS019990.
Citation: Heo HH, Sentell TL, Li D .
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
Prev Chronic Dis 2015 Sep 17;12:E152. doi: 10.5888/pcd12.150057.
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Keywords: Disparities, Racial and Ethnic Minorities, Hospitalization, Prevention, Chronic Conditions
Smith MW, Friedman B, Karaca Z
AHRQ Author: Friedman B, Karaca Z, Wong HS
Predicting inpatient hospital payments in the United States: a retrospective analysis.
The researchers evaluated whether payment-to-charge ratios (PCRs) can be predicted for hospitals in States that do not provide detailed financial data. They found that inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance.
AHRQ-authored.
Citation: Smith MW, Friedman B, Karaca Z .
Predicting inpatient hospital payments in the United States: a retrospective analysis.
BMC Health Serv Res 2015 Sep 10;15(1):372. doi: 10.1186/s12913-015-1040-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Healthcare Costs, Hospitalization
Page DB, Donnelly JP, Wang HE
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
The researchers sought to compare and contrast community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis hospitalizations in a national hospital sample. They found that hospital-acquired severe sepsis was associated with both higher mortality and resource utilization than community-acquired severe sepsis and healthcare-associated severe sepsis.
AHRQ-funded; HS013852.
Citation: Page DB, Donnelly JP, Wang HE .
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
Crit Care Med 2015 Sep;43(9):1945-51. doi: 10.1097/ccm.0000000000001164..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Hospitalization
Tilden EL, Lee VR, Allen AJ
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
The purpose of this study was to assess the outcomes and costs of hospital admission during the latent versus active phase of labor. It found that delaying admission until active labor would result in 672,000 fewer epidurals, 67,232 fewer cesarean deliveries, and 9.6 fewer maternal deaths in our theoretic cohort as compared to admission during latent labor.
AHRQ-funded; HS017582.
Citation: Tilden EL, Lee VR, Allen AJ .
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
Birth 2015 Sep;42(3):219-26. doi: 10.1111/birt.12179..
Keywords: Labor and Delivery, Comparative Effectiveness, Healthcare Costs, Patient-Centered Outcomes Research, Hospitalization
Pop-Vicas A, Rahman M, Gozalo PL
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
This study estimated the effect of influenza vaccination on hospitalization and mortality in nursing home (NH) residents. It found that the association between vaccine match and reduction in overall mortality and pneumonia and influenza hospitalizations was strongest for A/H3N2, the influenza strain typically responsible for the most-severe influenza cases.
AHRQ-funded; HS018462.
Citation: Pop-Vicas A, Rahman M, Gozalo PL .
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
J Am Geriatr Soc 2015 Sep;63(9):1798-804. doi: 10.1111/jgs.13617..
Keywords: Influenza, Nursing Homes, Vaccination, Hospitalization