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
26 to 50 of 93 Research Studies DisplayedPlantinga 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
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
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
Casucci S, Lin L, Hewner S
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
The purpose of this study was to demonstrate how observational causal inference methods can generate insights into the impact of chronic disease combinations on patients' 30-day hospital readmissions. The investigators concluded that multi-hypothesis causal analysis, a new methodological tool, generates meaningful insights from health care claims data, guiding the design of care and intervention programs.
AHRQ-funded; HS022575.
Citation: Casucci S, Lin L, Hewner S .
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
J Am Med Inform Assoc 2018 Jun;25(6):670-78. doi: 10.1093/jamia/ocx141.
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Keywords: Chronic Conditions, Hospital Readmissions, Medicaid, Hospitals
Middleton A, Graham JE, Ottenbacher KJ
Functional status is associated with 30-day potentially preventable hospital readmissions after inpatient rehabilitation among aged Medicare fee-for-service beneficiaries.
This study has two purposes: Determine the association between functional status of patients at discharge following inpatient rehabilitation and their potentially preventable readmission; Examine conditions that result in potentially preventable readmissions. The study examined inpatient rehabilitation facilities that submitted claims to Medicare, and concluded that functional status is associated with readmission and this may help to identify at-risk patients.
AHRQ-funded; HS022134.
Citation: Middleton A, Graham JE, Ottenbacher KJ .
Functional status is associated with 30-day potentially preventable hospital readmissions after inpatient rehabilitation among aged Medicare fee-for-service beneficiaries.
Arch Phys Med Rehabil 2018 Jun;99(6):1067-76. doi: 10.1016/j.apmr.2017.05.001..
Keywords: Elderly, Quality of Care, Hospital Discharge, Hospital Readmissions, Medicare
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
Smith AB, Meyer AM, Meng K
The relationship of travel distance with cystectomy access and outcomes.
The objectives of this study was to evaluate the effect of differential distance on cystectomy receipt among patients with muscle-invasive bladder cancer (MIBC) and investigate the association between travel distance and cystectomy outcomes such as readmission. The investigators found that the additional distance needed to reach a cystectomy provider did not predict receipt of surgery for MIBC. Furthermore, travel distance from cystectomy provider was not a significant predictor for subsequent readmission after cystectomy and did not affect overall survival.
AHRQ-funded; HS024134.
Citation: Smith AB, Meyer AM, Meng K .
The relationship of travel distance with cystectomy access and outcomes.
Urol Oncol 2018 Jun;36(6):308.e1-08.e9. doi: 10.1016/j.urolonc.2018.03.005..
Keywords: Access to Care, Cancer, Hospital Readmissions, Outcomes, Surgery
Shy BD, Loo GT, Lowry T
Bouncing back elsewhere: multilevel analysis of return visits to the same or a different hospital after initial emergency department presentation.
In this study, the investigators use a health information exchange network to describe differences between emergency department (ED) visits resulting in 72-hour revisits to the same hospital and those resulting in revisits to a different site. Their analysis describes how ED encounters with early revisits to the same hospital differ from those with revisits to a second hospital.
AHRQ-funded; HS021261.
Citation: Shy BD, Loo GT, Lowry T .
Bouncing back elsewhere: multilevel analysis of return visits to the same or a different hospital after initial emergency department presentation.
Ann Emerg Med 2018 May;71(5):555-63.e1. doi: 10.1016/j.annemergmed.2017.08.023..
Keywords: Emergency Department, Health Information Exchange (HIE), Hospital Readmissions, Quality Improvement
Nuckols TK, Fingar KR, Barrett ML
AHRQ Author: Steiner CA, Stocks C, Owens PL
Returns to emergency department, observation, or inpatient care within 30 days after hospitalization in 4 states, 2009 and 2010 versus 2013 and 2014.
This study described trends in rates of 30-day, all-cause, unplanned returns to the hospital, including returns for observation stays and ED visits. Increases in observation and ED visits coincided with declines in readmissions for private insurance and Medicare. Return rates rose among patients with Medicaid and the uninsured.
AHRQ-authored.
Citation: Nuckols TK, Fingar KR, Barrett ML .
Returns to emergency department, observation, or inpatient care within 30 days after hospitalization in 4 states, 2009 and 2010 versus 2013 and 2014.
J Hosp Med 2018 May;13(5):296-303. doi: 10.12788/jhm.2883.
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Keywords: Emergency Department, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Hospital Readmissions
Ma C, Shang J, Miner S
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
This systematic review examined the current evidence about hospital readmissions from home health care (HHC). Among 18 reviewed articles, they found that reported readmission rates and risk factors varied dramatically between studies; reasons for readmissions were understudied; and findings were limited by small sample sizes, single data source, and methodological flaws. They recommended that future studies use multiple national data sources across patients’ care spectrum and advanced statistical models to identify who among HHC patients are most likely to be readmitted to hospital and for what reason.
AHRQ-funded; HS023593.
Citation: Ma C, Shang J, Miner S .
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
Home Health Care Manag Pract 2018 May;30(2):83-92.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Home Healthcare, Hospital Readmissions
Nguyen OK, Makam AN, Clark C
Predicting 30-day hospital readmissions in acute myocardial infarction: the AMI "READMITS" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systo
This study sought to develop an actionable and accurate acute myocardial infarction (AMI) readmission risk prediction model to identify high-risk patients as early as possible during hospitalization. The investigators found that the parsimonious AMI READMITS score enables early prospective identification of high-risk AMI patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full-stay AMI readmission model only modestly outperformed the AMI READMITS score in terms of discrimination, but surprisingly did not meaningfully improve reclassification.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Predicting 30-day hospital readmissions in acute myocardial infarction: the AMI "READMITS" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systo
J Am Heart Assoc 2018 Apr 17;7(8). doi: 10.1161/jaha.118.008882..
Keywords: Hospital Readmissions, Heart Disease and Health, Provider Performance, Risk
Bachmann JM, Shah AS, Duncan MS
Cardiac rehabilitation and readmissions after heart transplantation.
Cardiac transplant recipients always are referred to cardiac rehabilitation (CR) after transplantation, and is associated with a lower 1-year readmission risk. This study’s objective was to determine rates of CR for heart transplant recipients in the US and also 1-year readmission rates using 2013-2014 Medicare data. Out of the 2,531 heart transplant patients in the US in 2013, about 24% received Medicare coverage and were included in the study. Rates of CR utilization was only, with only 55% participating in the program. Younger transplant patients ages 35 to 49 years were less likely to initiate CR than patients 65 and older. In all groups patients did not attend all 36 prescribed sessions, with a mean of 26.7 sessions attended. The 1-year readmission risk was 29% lower for CR participation patients.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Shah AS, Duncan MS .
Cardiac rehabilitation and readmissions after heart transplantation.
J Heart Lung Transplant 2018 Apr;37(4):467-76. doi: 10.1016/j.healun.2017.0.017.
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Keywords: Transplantation, Surgery, Rehabilitation, Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wickremasinghe AC, Kuzniewicz MW, McCulloch CE
Efficacy of subthreshold newborn phototherapy during the birth hospitalization in preventing readmission for phototherapy.
The purpose of this study was to estimate the efficacy of subthreshold phototherapy for newborns with total serum bilirubin (TSB) levels from 0.1 to 3.0 mg/dL below the appropriate AAP phototherapy threshold during the birth hospitalization in preventing readmissions for phototherapy, and to identify predictors of readmission for phototherapy. The investigators concluded that subthreshold phototherapy during the birth hospitalization is effective in preventing readmissions for phototherapy; however, for each readmission prevented, many newborns require phototherapy who would otherwise not need it.
AHRQ-funded; HS020618.
Citation: Wickremasinghe AC, Kuzniewicz MW, McCulloch CE .
Efficacy of subthreshold newborn phototherapy during the birth hospitalization in preventing readmission for phototherapy.
JAMA Pediatr 2018 Apr;172(4):378-85. doi: 10.1001/jamapediatrics.2017.5630..
Keywords: Children/Adolescents, Evidence-Based Practice, Hospital Readmissions, Hospitalization, Inpatient Care, Newborns/Infants
Middleton A, Downer B, Haas A
Functional status is associated with 30-day potentially preventable readmissions following skilled nursing facility discharge among Medicare beneficiaries.
This retrospective cohort study’s objective was to determine the association between patients’ functional status at discharge from skilled nursing facility (SNF) care and 30-day potentially preventable readmissions. Data was used from a national cohort of Medicare fee-for-service beneficiaries discharged from SNF care from July 2013 to July 2014. The average age was 81.4 years, 67% were women, and 86.3% non-Hispanic white. Functional data used from the Minimum Data Set was self-care, mobility, and cognition domains. The overall rate of 30-day potentially preventable readmissions was 5.7%. The 5 most common conditions for readmissions were congestive heart failure, septicemia, urinary tract infection, bacterial pneumonia, and renal failure. Mobility was the most dependent category followed by self-care and cognition.
AHRQ-funded; HS022134.
Citation: Middleton A, Downer B, Haas A .
Functional status is associated with 30-day potentially preventable readmissions following skilled nursing facility discharge among Medicare beneficiaries.
J Am Med Dir Assoc 2018 Apr;19(4):348-54.e4. doi: 10.1016/j.jamda.2017.12.003..
Keywords: Hospital Readmissions, Hospital Discharge, Hospitals, Medicare, Elderly
Cartmell KB, Dooley M, Mueller M
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
This study explored the effect of an inpatient tobacco dependence treatment services (TDTS) on 30-, 90-, and 180-day hospital readmissions. The investigators suggest that findings from their study, which are supported by prior studies, provide evidence that delivery of TDTS is a strategy that may help to reduce hospital readmissions.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dooley M, Mueller M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
Med Care 2018 Apr;56(4):358-63. doi: 10.1097/mlr.0000000000000884..
Keywords: Evidence-Based Practice, Hospital Readmissions, Substance Abuse, Tobacco Use
Horwitz LI, Wang Y, Altaf FK
Hospital characteristics associated with postdischarge hospital readmission, observation, and emergency department utilization.
In this cross-sectional analysis, the authors found that including emergency department and observation stays in measures of postdischarge utilization produced similar results as measuring only readmissions, in that major teaching, urban and for-profit hospitals still perform disproportionately poorly versus nonteaching or public hospitals.
AHRQ-funded; HS022882.
Citation: Horwitz LI, Wang Y, Altaf FK .
Hospital characteristics associated with postdischarge hospital readmission, observation, and emergency department utilization.
Med Care 2018 Apr;56(4):281-89. doi: 10.1097/mlr.0000000000000882..
Keywords: Emergency Department, Hospital Readmissions, Hospitalization
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
Yarbrough CK, Bommarito KM, Gamble PG
Population-based approaches to treatment and readmission after spinal cord injury.
Recent studies in surgical and non-surgical specialties have suggested that patients admitted on the weekend may have worse outcomes. It is unclear whether this extends to patients with spinal cord injury (SCI). This study was designed to evaluate factors for readmission after index hospitalization for spinal cord injury. The study’s results suggested that the weekend effect, described previously in other patient populations, may not play as important a role in patients with SCI.
AHRQ-funded; HS019455.
Citation: Yarbrough CK, Bommarito KM, Gamble PG .
Population-based approaches to treatment and readmission after spinal cord injury.
J Neurosurg Sci 2018 Apr;62(2):107-15. doi: 10.23736/s0390-5616.16.03617-1..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Outcomes, Injuries and Wounds
Sterling MR, Safford MM, Goggins K
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the post hospitalization period. The purpose of this study was to examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF).
AHRQ-funded; HS000066.
Citation: Sterling MR, Safford MM, Goggins K .
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
J Hosp Med 2018 Mar;13(3):145-51. doi: 10.12788/jhm.2932..
Keywords: Health Literacy, Hospital Readmissions, Hospitalization, Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Risk
Sills MR, Macy ML, Kocher KE
Return visit admissions may not indicate quality of emergency department care for children.
The goal of this retrospective analysis was to test the hypothesis that in-hospital outcomes are worse among children admitted during a return ED visit than among those admitted during an index visit. Children who were hospitalized in Florida and New York hospitals during a return visit within 7 days were classified as "ED return admissions" or "readmissions"; in-hospital outcomes for ED return admissions and readmissions were compared to "index admissions without return admission". The results indicate that children who are initially discharged from the ED and then have a return admission had lower severity but similar cost in comparison with children who experienced an index admission without a return admission. The authors conclude that this suggests that ED return visit admissions do not involve worse outcomes than index admissions.
AHRQ-funded; HS024160; HS016418.
Citation: Sills MR, Macy ML, Kocher KE .
Return visit admissions may not indicate quality of emergency department care for children.
Acad Emerg Med 2018 Mar;25(3):283-92. doi: 10.1111/acem.13324..
Keywords: Children/Adolescents, Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitals, Quality of Care, Outcomes
Berry JG, Gay JC, Joynt Maddox K
Age trends in 30 day hospital readmissions: US national retrospective analysis.
This study assessed trends in and risk factors for readmission to hospital across the age continuum. It concluded that the likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions.
AHRQ-funded; HS023092.
Citation: Berry JG, Gay JC, Joynt Maddox K .
Age trends in 30 day hospital readmissions: US national retrospective analysis.
BMJ 2018 Feb 27;360:k497. doi: 10.1136/bmj.k497.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Risk
Ibrahim AM, Dimick JB, Sinha SS
Association of coded severity with readmission reduction after the hospital readmissions reduction program.
This research letter describes a study which examined coding by hospitals used to determine rates of readmission under the Hospital Readmission Reduction Program (HRRP). Hospitals who go above a certain rate are subject to financial penalties for 3 targed medical conditions. It was determined that hospitals have begun to change their coding to show increased severity of illness in many of those readmissions. Data came from discharges from the Medicare Provider Analysis and review file between 2008 and 2014. Researchers compared coding severity levels from before HRRP was implemented and post April 1, 2010 when it began.
AHRQ-funded; HS024525; HS024728.
Citation: Ibrahim AM, Dimick JB, Sinha SS .
Association of coded severity with readmission reduction after the hospital readmissions reduction program.
JAMA Intern Med 2018 Feb;178(2):290-92. doi: 10.1001/jamainternmed.2017.6148..
Keywords: Hospital Readmissions, Hospitals, Medicare, Policy
Gay JC, Hall M, Markham JL
Association of extending hospital length of stay with reduced pediatric hospital readmissions.
This article describes a retrospective cohort study of hospitalized children (aged 0-18years) using data from 2015 to 2016 from the Pediatric Health Information System database (Children’s Hospital Association), which includes clinical and billing data from 49 children’s hospitals, representing approximately 20% of all US discharges for children.
AHRQ-funded; HS024453.
Citation: Gay JC, Hall M, Markham JL .
Association of extending hospital length of stay with reduced pediatric hospital readmissions.
JAMA Pediatr 2018 Feb;173(2):186-88. doi: 10.1001/jamapediatrics.2018.3815..
Keywords: Children/Adolescents, Hospital Readmissions, Hospitalization
Arms MA, Fleming J, Sangani DB
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
This longitudinal cohort study examined 3 cohorts (no readmissions, readmissions not due to an adverse drug event, and adverse drug events contributing to readmissions) of adult kidney recipients transplanted between 2005 and 2010 and followed through 2013. The study results demonstrated that adverse drug events may be associated with a significant increase in the risk of hospital readmission after kidney transplant and subsequent graft loss.
AHRQ-funded; HS023754
Citation: Arms MA, Fleming J, Sangani DB .
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
Surgery 2018 Feb;163(2):430-35. doi: 10.1016/j.surg.2017.09.027..
Keywords: Adverse Drug Events (ADE), Patient Safety, Hospital Readmissions, Transplantation
Sentell T, Ahn HJ, Miyamura J
Thirty-day inpatient readmissions for Asian American and Pacific Islander subgroups compared with whites.
The authors of this study used Hawaii Health Information Corporation data from 2007-2012 statewide adult hospitalizations (N = 495,910) to compare the Asian and Pacific Islander (API) subgroup and White potentially preventable readmissions (PPRs). The authors suggest that distinct PPR characteristics across API subpopulations and age groups can inform policy and practice.
AHRQ-funded; HS019990.
Citation: Sentell T, Ahn HJ, Miyamura J .
Thirty-day inpatient readmissions for Asian American and Pacific Islander subgroups compared with whites.
Med Care Res Rev 2018 Feb;75(1):100-26. doi: 10.1177/1077558716676595..
Keywords: Racial and Ethnic Minorities, Hospital Readmissions