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
101 to 125 of 145 Research Studies DisplayedZhang H, Masoudi FA, Li J
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
The objective of this study was to perform a national quality assessment of early β-blocker use during hospitalization for AMI over the past decade in China. It found that the use of early β-blocker therapy for patients with AMI in China is suboptimal, with underuse in patients who could benefit and substantial use among those who might be harmed.
AHRQ-funded; HS023000.
Citation: Zhang H, Masoudi FA, Li J .
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
Am Heart J 2015 Sep;170(3):506-15.e1. doi: 10.1016/j.ahj.2015.05.012..
Keywords: Heart Disease and Health, Hospitalization, Patient-Centered Outcomes Research, Quality of Care
Kuo YF, Chen NW, Baillargeon J
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
The researchers compared the rates of potentially preventable hospitalizations in older diabetic patients who received primary care from nurse practitioners (NPs) only versus those who received care from primary care physicians only. Using potentially preventable hospitalizations as a quality indicator, they found that primary care provided by NPs was at least comparable with that provided by generalist physicians.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Chen NW, Baillargeon J .
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
Med Care 2015 Sep;53(9):776-83. doi: 10.1097/mlr.0000000000000406..
Keywords: Hospitalization, Primary Care, Comparative Effectiveness, Diabetes
Guo MW, Ahn HJ, Juarez DT
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older. It found that Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups.
AHRQ-funded; HS019990.
Citation: Guo MW, Ahn HJ, Juarez DT .
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
Prev Chronic Dis 2015 Aug 6;12:E124. doi: 10.5888/pcd12.150092..
Keywords: Mortality, Hospitalization, Diabetes, Racial and Ethnic Minorities, Elderly
Berry JG, Zaslavsky AM, Toomey SL
Recognizing differences in hospital quality performance for pediatric inpatient care.
This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3,974 hospitals in 44 states in the 2009 Kids’ Inpatient Database. It found that most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modest differences in performance from average, but most condition-specific measures do not.
AHRQ-funded; HS020513.
Citation: Berry JG, Zaslavsky AM, Toomey SL .
Recognizing differences in hospital quality performance for pediatric inpatient care.
Pediatrics 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Quality of Care
Grebla RC, Keohane L, Lee Y
Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase.
The authors compared hospital and postacute skilled nursing facility utilization among Medicare Advantage enrollees in matched plans that did or did not eliminate that requirement in 2006-10. Among hospitalized enrollees with a skilled nursing facility admission, the mean hospital length-of-stay declined for those no longer subject to the qualifying stay but increased among those still subject to it. The elimination of the three-day-stay requirement was not associated with more hospital or skilled nursing facility admissions or with longer lengths-of-stay in a skilled nursing facility.
AHRQ-funded; HS000011.
Citation: Grebla RC, Keohane L, Lee Y .
Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase.
Health Aff 2015 Aug;34(8):1324-30. doi: 10.1377/hlthaff.2015.0054.
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Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Patient-Centered Outcomes Research
Moore JX, Donnelly JP, Griffin R
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
The researchers sought to characterize racial differences in incident sepsis in a large cohort of adult community-dwelling adults. They found that in the REGARDS cohort, black participants were less likely than white participants to experience infection and sepsis events.
AHRQ-funded; HS013852.
Citation: Moore JX, Donnelly JP, Griffin R .
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
Crit Care 2015 Jul 10;19:279. doi: 10.1186/s13054-015-0992-8..
Keywords: Racial and Ethnic Minorities, Disparities, Hospitalization, Racial and Ethnic Minorities
Bell ML, Son JY, Peng RD
Ambient PM2.5 and risk of hospital admissions: do risks differ for men and women?
The researchers conducted a multi-site time-series analysis of short-term fine particulate matter (PM) exposure and cardiovascular and respiratory hospital admissions among older persons to examine whether effects differ by sex. They found that women may be more susceptible to PM2.5-related hospitalizations for some respiratory and cardiovascular causes.
AHRQ-funded; HS021991.
Citation: Bell ML, Son JY, Peng RD .
Ambient PM2.5 and risk of hospital admissions: do risks differ for men and women?
Epidemiology 2015 Jul;26(4):575-9. doi: 10.1097/ede.0000000000000310..
Keywords: Elderly, Hospitalization, Respiratory Conditions, Cardiovascular Conditions
Williams DJ, Edwards KM, Self WH
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
The 2011 national guidelines for the management of childhood community-acquired pneumonia (CAP) recommended narrow-spectrum antibiotics (e.g., ampicillin) for most children hospitalized with CAP. The researchers assessed the impact of these guidelines on antibiotic prescribing at 3 children’s hospitals. They found that, after publication of national guidelines, third-generation cephalosporin use declined and penicillin/ampicillin use increased among children hospitalized with CAP.
AHRQ-authored; HS022342.
Citation: Williams DJ, Edwards KM, Self WH .
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
Pediatrics 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047..
Keywords: Children/Adolescents, Hospitalization, Guidelines, Medication, Practice Patterns
Carey K
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
This paper investigates the relationship between length of stay and readmission within 30 days of discharge from an acute care hospitalization. It found that the cost of an additional day of stay was offset by expected cost savings from an avoided readmission in the range of 15 to 65 percent.
AHRQ-funded; HS020995.
Citation: Carey K .
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
Health Econ 2015 Jul;24(7):790-802. doi: 10.1002/hec.3061..
Keywords: Hospital Readmissions, Hospitalization, Elderly, Hospital Discharge, Medicare
Briesacher BA, Madden JM, Zhang F
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
The researchers examined changes in health outcomes and medical services in the Medicare population after implementation of Medicare Part D. They found that 5 years after implementation, and contrary to previous reports, there was no evidence of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
AHRQ-funded; HS018577
Citation: Briesacher BA, Madden JM, Zhang F .
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
Ann Intern Med. 2015 Jun 16;162(12):825-33. doi: 10.7326/m14-0726..
Keywords: Hospitalization, Outcomes, Medicare, Health Status, Elderly
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
Because laboratory testing and coding for rotavirus are not routinely performed for patients with diarrhea, the researchers examined both all-cause acute gastroenteritis and rotavirus-coded hospitalizations among children younger than 5 years from 2000 through 2012. They found that, in 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations.
AHRQ-authored.
Citation: Leshem E, Tate JE, Steiner CA .
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
JAMA 2015 Jun 9;313(22):2282-4. doi: 10.1001/jama.2015.5571..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination, Children/Adolescents, Adverse Events
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
AHRQ-funded; HS020667.
Citation: Duseja R, Bardach NS, Lin GA .
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department, Hospitalization, Hospital Readmissions
Iroh Tam PY, Bernstein E, Ma X
Blood culture in evaluation of pediatric community-acquired pneumonia: a systematic review and meta-analysis.
The researchers systematically reviewed the international pediatric literature to evaluate how often blood cultures (BCs) are positive in hospitalized children with CAP, identify the most commonly isolated pathogens, and determine the impact of positive BCs on clinical management. They found that BCs in pediatric CAP identified organisms in only a small percentage of patients, predominantly S. pneumoniae. False-positive BC rates can be substantial.
AHRQ-funded; HS020666.
Citation: Iroh Tam PY, Bernstein E, Ma X .
Blood culture in evaluation of pediatric community-acquired pneumonia: a systematic review and meta-analysis.
Hosp Pediatr 2015 Jun;5(6):324-36. doi: 10.1542/hpeds.2014-0138..
Keywords: Children/Adolescents, Hospitalization, Children/Adolescents, Comparative Effectiveness
Spector WD, Limcangco R, Mutter RL
AHRQ Author: Spector WD, Mutter RL, Owens P
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
The study objective was to explore the association of clinical and nonclinical factors with the decision to admit ED patients with injury. It found that injury location, type, and mechanism and comorbidities had large effects on hospitalization rates as expected. We found higher inpatient admission rates by level of trauma center designation and hospital size, but findings differed by age and type of injury.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Mutter RL .
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
Am J Emerg Med 2015 Jun;33(6):764-9. doi: 10.1016/j.ajem.2015.02.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Emergency Department
Keohane LM, Grebla RC, Mor V
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
In 2011, new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in Medicare Advantage (MA) plans. The authors found that some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing.
AHRQ-funded; HS000011.
Citation: Keohane LM, Grebla RC, Mor V .
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
Health Aff 2015 Jun;34(6):1019-27. doi: 10.1377/hlthaff.2014.1146.
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Keywords: Healthcare Costs, Hospitalization, Policy, Medicare, Nursing Homes
Seitz AE, Adjemian J, Steiner CA
AHRQ Author: Steiner CA
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
The researchers used a single, multi-state dataset with standard methodology throughout the endemic area to provide new insights into the epidemiology of blastomycosis. They found that the odds of a county being part of a high-risk cluster was associated with increasing percentage of population over age 65, decreasing maximum temperature, increasing mercury, and decreasing copper soil content.
AHRQ-authored.
Citation: Seitz AE, Adjemian J, Steiner CA .
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
Med Mycol 2015 Jun;53(5):447-54. doi: 10.1093/mmy/myv014..
Keywords: Risk, Hospitalization, Elderly, Healthcare Cost and Utilization Project (HCUP)
Allen LaPointe NM, Dai D, Thomas L
Comparisons of hospitalization rates among younger atrial fibrillation patients receiving different antiarrhythmic drugs.
The purpose of this study was to compare hospitalization rates after the initiation of different anti-arrhythmic drugs (AADs) in clinical practice among AF patients <65 years of age who did not have coronary artery disease (CAD) or heart failure. Differences in hospitalization rates were found between AADs in younger AF patients without structural heart disease, with amiodarone having the lowest risk of AF hospitalization.
AHRQ-funded; HS021092.
Citation: Allen LaPointe NM, Dai D, Thomas L .
Comparisons of hospitalization rates among younger atrial fibrillation patients receiving different antiarrhythmic drugs.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):292-300. doi: 10.1161/circoutcomes.114.001499..
Keywords: Hospitalization, Heart Disease and Health, Medication, Cardiovascular Conditions
Press VG, Matthiesen MI, Ranadive A
Insights into inpatients with poor vision: a high value proposition.
The researchers studied the initial feasibility and efficacy of screening and correcting inpatients’ vision. Over 800 hospitalized patients’ vision was screened. Those participants who failed a vision screen (Snellen chart) test performed by research assistants were given non-prescription readers that corrected most participants’ vision.
AHRQ-funded; HS016967.
Citation: Press VG, Matthiesen MI, Ranadive A .
Insights into inpatients with poor vision: a high value proposition.
J Hosp Med 2015 May;10(5):311-3. doi: 10.1002/jhm.2342..
Keywords: Eye Disease and Health, Screening, Inpatient Care, Hospitalization
Hernandez-Boussard T, McDonald KM, Rhoads KF
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
The study’s aim was to assess risk-adjusted rates of inpatient adverse events (AEs) for general reconstructive soft tissue procedures using established measures. It found that plastic surgery patients had a significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, McDonald KM, Rhoads KF .
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
Ann Plast Surg 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Inpatient Care, Hospitalization, Patient Safety
Chopra V, Fallouh N, McGuirk H
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
The purpose of this study was to determine patterns, risk factors and treatment related to peripherally inserted central catheters-deep vein thrombosis (PICC-DVT) in hospitalized patients. It found that treatment for PICC-DVT varied and included heparin bridging, low molecular weight heparin only and device removal only; the average duration of treatment also varied across these groups.
AHRQ-funded; HS022835.
Citation: Chopra V, Fallouh N, McGuirk H .
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
Thromb Res 2015 May;135(5):829-34. doi: 10.1016/j.thromres.2015.02.012..
Keywords: Patient Safety, Blood Clots, Blood Thinners, Risk, Hospitalization
Eapen ZJ, McCoy LA, Fonarow CG
Utility of socioeconomic status in predicting 30-day outcomes after heart failure hospitalization.
The researchers investigated whether accounting for socioeconomic status (SES) can improve risk-adjusted models for 30-day outcomes among CMS beneficiaries hospitalized with heart failure. They found that county-level SES data are modestly associated with 30-day outcomes but do not improve risk adjustment models based on patient characteristics alone.
AHRQ-funded; HS021092.
Citation: Eapen ZJ, McCoy LA, Fonarow CG .
Utility of socioeconomic status in predicting 30-day outcomes after heart failure hospitalization.
Circ Heart Fail 2015 May;8(3):473-80. doi: 10.1161/circheartfailure.114.001879.
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Keywords: Shared Decision Making, Heart Disease and Health, Hospitalization, Patient-Centered Outcomes Research, Social Determinants of Health
Jones CD, Vu MB, O'Donnell CM
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
The purpose of this study was to understand the challenges in coordination of care, as well as potential solutions, from the perspective of hospitalists and PCPs in North Carolina. Hospitalists and PCPs were found to encounter similar care coordination challenges, including (1) lack of time, (2) difficulty reaching other clinicians, and (3) lack of personal relationships with other clinicians.
AHRQ-funded; HS020940.
Citation: Jones CD, Vu MB, O'Donnell CM .
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
J Gen Intern Med 2015 Apr;30(4):417-24. doi: 10.1007/s11606-014-3056-x..
Keywords: Care Coordination, Communication, Hospital Discharge, Hospitalization, Primary Care
Lund BC, Schroeder MC, Middendorff G
Effect of hospitalization on inappropriate prescribing in elderly Medicare beneficiaries.
This study sought to determine whether acute hospitalization is associated with a change in potentially inappropriate medication (PIM) use and whether use varies across geographic region. It found that despite intervention studies demonstrating up to 80% reduction in PIM use during acute hospitalization, a significant increase in PIM use was observed in a naturalistic setting in Medicare beneficiaries with acute myocardial acute myocardial infarction.
AHRQ-funded; HS018381.
Citation: Lund BC, Schroeder MC, Middendorff G .
Effect of hospitalization on inappropriate prescribing in elderly Medicare beneficiaries.
J Am Geriatr Soc 2015 Apr;63(4):699-707. doi: 10.1111/jgs.13318..
Keywords: Hospitalization, Medicare, Elderly, Medication
Tangri N, Miskulin DC, Zhou J
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
The researchers studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. They concluded that a higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.
AHRQ-funded; 290200500341I.
Citation: Tangri N, Miskulin DC, Zhou J .
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
Nephrol Dial Transplant 2015 Apr;30(4):667-75. doi: 10.1093/ndt/gfu349.
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Keywords: Comparative Effectiveness, Hospitalization, Kidney Disease and Health, Cardiovascular Conditions, Treatments
Beadles CA, Ellis AR, Lichstein JC
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
This study examined the timing of first outpatient follow-up and subsequent health care utilization for adults with serious mental illness (major depression or schizophrenia) and comorbid general medical conditions. It found that for patients not readmitted within 30 days, follow-up within 30 days appeared to be beneficial on the basis of subsequent service utilization.
AHRQ-funded; HS019659; HS000032.
Citation: Beadles CA, Ellis AR, Lichstein JC .
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
Psychiatr Serv 2015 Apr;66(4):364-72. doi: 10.1176/appi.ps.201400081..
Keywords: Hospitalization, Behavioral Health, Healthcare Utilization, Ambulatory Care and Surgery