National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (4)
- Adverse Events (8)
- Behavioral Health (1)
- Blood Pressure (2)
- Blood Thinners (2)
- Cancer (1)
- (-) Cardiovascular Conditions (99)
- Care Coordination (1)
- Care Management (1)
- Case Study (3)
- Children/Adolescents (4)
- Chronic Conditions (10)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (2)
- Critical Care (1)
- Data (1)
- Dementia (1)
- Depression (1)
- Diabetes (3)
- Diagnostic Safety and Quality (4)
- Dialysis (1)
- Disabilities (1)
- Disparities (4)
- Education: Continuing Medical Education (1)
- Elderly (13)
- Electronic Health Records (EHRs) (4)
- Emergency Department (3)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (18)
- Guidelines (2)
- Healthcare Costs (5)
- Healthcare Delivery (3)
- Healthcare Utilization (4)
- Health Information Technology (HIT) (8)
- Health Status (4)
- Heart Disease and Health (66)
- Home Healthcare (1)
- Hospital Discharge (3)
- Hospitalization (9)
- Hospital Readmissions (4)
- Hospitals (8)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (4)
- Implementation (3)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (5)
- Long-Term Care (1)
- Medical Devices (2)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (8)
- Medication (18)
- Medication: Safety (2)
- Men's Health (1)
- Mortality (12)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing Homes (4)
- Nutrition (1)
- Outcomes (18)
- Palliative Care (2)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (23)
- Patient Adherence/Compliance (5)
- Patient and Family Engagement (1)
- Patient Safety (7)
- Pneumonia (1)
- Policy (2)
- Practice Patterns (6)
- Prevention (8)
- Primary Care (8)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality Improvement (12)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (12)
- Quality of Life (2)
- Racial and Ethnic Minorities (1)
- Registries (7)
- Rehabilitation (3)
- Research Methodologies (2)
- Respiratory Conditions (4)
- Risk (19)
- Rural Health (1)
- Screening (2)
- Sex Factors (2)
- Sexual Health (1)
- Shared Decision Making (6)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Stroke (10)
- Surgery (18)
- Telehealth (2)
- Transitions of Care (3)
- Transplantation (2)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (3)
- Urban Health (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 99 Research Studies DisplayedMefford MT, Sephel A, Van Dyke MK
Medication-taking behaviors and perceptions among adults with heart failure (from the REasons for Geographic And Racial Differences in Stroke Study).
Medication regimens in adults with heart failure (HF) are complex which can complicate patient adherence. Individuals with HF frequently use beta blockers (BBs) for multiple indications, including hypertension and HF, but BBs can have significant side effects that may affect their use. In this study, the investigators examined medication-taking behaviors and perceptions in individuals with HF, with a particular focus on BBs.
AHRQ-funded; HS013852.
Citation: Mefford MT, Sephel A, Van Dyke MK .
Medication-taking behaviors and perceptions among adults with heart failure (from the REasons for Geographic And Racial Differences in Stroke Study).
Am J Cardiol 2019 May 15;123(10):1667-74. doi: 10.1016/j.amjcard.2019.02.024..
Keywords: Medication, Heart Disease and Health, Cardiovascular Conditions, Patient Adherence/Compliance
Strom JB, Shen C, Yeh RW
SCOT-HEART: does it live up to the PROMISE?
This paper examines the Scottish Computed Tomography of the Heart (SCOT-HEART) trial which was a prospective, openlabel, parallel group, multicenter trial that randomized 4146 adults (ages 18–75), referred for suspected angina to 12 cardiology clinics across Scotland between November 18, 2010 and September 24, 2014, to an initial strategy of computed tomographic Angiography (CTA) plus standard care or standard care alone in a 1:1 fashion.
AHRQ-funded; R01 HS024520.
Citation: Strom JB, Shen C, Yeh RW .
SCOT-HEART: does it live up to the PROMISE?
J Cardiovasc Comput Tomogr 2019 May - Jun;13(3):48-50. doi: 10.1016/j.jcct.2019.01.008..
Keywords: Imaging, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Hadler RA, Goldstein NE, Bekelman DB
"Why would i choose death?": a qualitative study of patient understanding of the role and limitations of cardiac devices.
The aim of this study was to assess perceptions of cardiac devices in patients with heart failure and how these perceptions impacted advance care planning and future expectations. The investigators found that patients, in their sample, with cardiac devices overestimated the impact of their devices on preventing disease progression and death and deprioritized advance care planning as a result.
AHRQ-funded; HS022989.
Citation: Hadler RA, Goldstein NE, Bekelman DB .
"Why would i choose death?": a qualitative study of patient understanding of the role and limitations of cardiac devices.
J Cardiovasc Nurs 2019 May/Jun;34(3):275-82. doi: 10.1097/jcn.0000000000000565..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Mortality, Palliative Care
Lindner S, Solberg LI, Miller WL
Does ownership make a difference in primary care practice?
This study looked into whether ownership of a primary care practice makes a difference in structural characteristics, quality improvement practices, and cardiovascular preventive care. This analysis was done was part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by AHRQ. Physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHCs) were compared using 15 survey-based measures, and 4 electronic health record-based cardiovascular disease (CVD) prevention quality measures known as ABCS (aspirin prevention, blood pressure control, cholesterol management, and smoking cessation support). Physician-owned practices were solo 45% of the time as opposed to 8.1% for health system practices and 12.8% for FQHCs. FQHCs were more likely to use quality improvement practices followed by health system practices. ABCS use was similar across ownership types with the exception of smoking cessation support.
AHRQ-funded; HS023940.
Citation: Lindner S, Solberg LI, Miller WL .
Does ownership make a difference in primary care practice?
J Am Board Fam Med 2019 May-Jun;32(3):398-407. doi: 10.3122/jabfm.2019.03.180271..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Quality Improvement, Quality of Care, Healthcare Delivery
Hannan EL, Barrett SC, Samadashvili Z
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
This study assessed the feasibility of retooling the paper-based New York State coronary artery bypass graft (CABG) surgery statistical model for mortality and readmission into a model for electronic health records (EHRs). Researchers found that only 6 data elements could be extracted from the EHR, and outlier hospitals differed for readmission but was usable for mortality. They concluded that the EHR model was inferior to the NYS model, and that simplifying the EHR risk model couldn’t capture most of the risk factors in the NYS model.
AHRQ-funded; HS022647.
Citation: Hannan EL, Barrett SC, Samadashvili Z .
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
Med Care 2019 May;57(5):377-84. doi: 10.1097/mlr.0000000000001104..
Keywords: Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Outcomes, Risk, Cardiovascular Conditions
Patel M, Boutin-Foster C, Phillips E
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
This study’s objective was to compare the understanding of cardiovascular disease (CVD) risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S. by surveying a sample group of immigrants in Queens, NY., Scores on the knowledge instrument used for the surveyed Bangladeshis were compared with Caucasians from the Coronary Artery Risk Development in Young Adults (CARDIA) study using multivariate regression modeling. The results of the study indicate that understanding of CVD risk factors was lower among Bangladeshis than whites, driven by the surveyed Bangladeshis having less awareness of how exercise and weight contribute to CVD risk. The authors recommend that community based interventions and health partnerships target these behavioral risk factors in the Bangladeshi population.
AHRQ-funded; HS000066.
Citation: Patel M, Boutin-Foster C, Phillips E .
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
Ethn Health 2019 May;24(4):432-42. doi: 10.1080/13557858.2017.1346191..
Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Risk, Urban Health
Sharma A, Sun JL, Lokhnygina Y
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
The authors of this article performed a hierarchical cluster analysis to identify acute coronary syndrome (ACS) patients at high risk for adverse clinical events. Post-ACS patients were randomized to ezetimibe+simvastatin or placebo+simvastatin. Ezetimibe's impact on outcomes across clusters; the ability of the cluster analysis to discriminate for outcomes was compared with the Global Registry of Acute Coronary Events (GRACE) score. Outcomes included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina, or coronary revascularization at least 30 days after randomization. Compared with GRACE, cluster analysis did not provide superior outcome discrimination. Consistent ezetimibe treatment effect was identified across clusters. The authors conclude that cluster analysis identified significant difference in risk of outcomes across cluster groups.
AHRQ-funded; HS023000.
Citation: Sharma A, Sun JL, Lokhnygina Y .
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
Am J Cardiol 2019 Apr 15;123(8):1193-201. doi: 10.1016/j.amjcard.2019.01.034..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Outcomes, Patient-Centered Outcomes Research, Risk
Assimon MM, Brookhart MA, Flythe JE
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
This retrospective cohort study compared cardiac safety of selective serotonin reuptake inhibitors (SSRIs) among individuals receiving maintenance hemodialysis. These individuals may be particularly susceptible to lethal cardiac consequences of drug-induced QT prolongation due to a substantial cardiovascular disease burden and their use of many medications. Data from a cohort of Medicare beneficiaries receiving hemodialysis included in the US Renal Data system registry from 2007-2014 was used. Researchers compared the 1-year risk of death among hemodialysis patients taking different SSRIs. Use of higher QT-prolonging potential SSRIs (citalopram, escitalopram) was associated with a higher risk of sudden cardiac death than patients taking lower risk SSRIs (fluoxetine, fluvoxamine, paroxetine, sertraline). The association was higher among elderly individuals, females, patients with conduction disorders, and those treated with other non-SSRI QT-prolonging medications.
AHRQ-funded; HS026801.
Citation: Assimon MM, Brookhart MA, Flythe JE .
Comparative cardiac safety of selective serotonin reuptake inhibitors among individuals receiving maintenance hemodialysis.
J Am Soc Nephrol 2019 Apr;30(4):611-23. doi: 10.1681/asn.2018101032..
Keywords: Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions
Gupta R, J J, Collins S
Diuretic resistance in heart failure.
Diuretic resistance (DR) occurs along a spectrum of relative severity and contributes to worsening of acute heart failure (AHF) during an inpatient stay. This review gives an overview of mechanisms of DR with a focus on loop diuretics and summarizes the current literature regarding the prognostic value of diuretic efficiency and predictors of natriuretic response in AHF.
AHRQ-funded; HS025411.
Citation: Gupta R, J J, Collins S .
Diuretic resistance in heart failure.
Curr Heart Fail Rep 2019 Apr;16(2):57-66. doi: 10.1007/s11897-019-0424-1..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Inpatient Care, Medication
Baik D, Reading M, Jia H
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
This cross-sectional study was conducted at an urban academic medical center to measure health status and symptom burdens of heart failure patients using a mHealth application called mi.Symptoms. Patients were diverse, with a mean age of 58.7, and were 37% women, 36% Black, and 36% Hispanic/Latino. Almost half were classified as New York Heart Association class III, and 44% reported not having enough income to make ends meet. Health status was measured with the Kansas City cardiomyopathy questionnaire clinical summary score. Predictors of better health status included higher physical function and ability to participate in social functions and activities. Predictors of poorer health status was New York Heart Association class IV status and dyspnea.
AHRQ-funded; HS021816.
Citation: Baik D, Reading M, Jia H .
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
Eur J Cardiovasc Nurs 2019 Apr;18(4):325-31. doi: 10.1177/1474515119825704..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Health Status, Telehealth, Health Information Technology (HIT)
Zullo AR, Mogul A, Corsi K
Association between secondary prevention medication use and outcomes in frail older adults after acute myocardial infarction.
In order to examine the effect of using more guideline-recommended medications after myocardial infarction on mortality, rehospitalization, and functional decline in the frailest and oldest segment of long-stay nursing home residents, researchers conducted a retrospective cohort study of U.S. nursing home residents aged 65 years or older. Exposure was the number of secondary prevention medications initiated after myocardial infarction; outcomes were 90-day death, rehospitalization, or functional decline. The results of the study indicate that the use of more guideline-recommended medications after myocardial infarction was associated with decreased mortality in older, predominantly frail adults, but there was no difference in rehospitalization. Functional decline outcomes were discordant and the researchers note that this does not rule out an increased risk associated with more medication use.
AHRQ-funded; HS022998.
Citation: Zullo AR, Mogul A, Corsi K .
Association between secondary prevention medication use and outcomes in frail older adults after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2019 Apr;12(4):e004942. doi: 10.1161/circoutcomes.118.004942..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research, Prevention
Weerahandi H, Li L, Bao H
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
The goal of this study was to examine outcomes for Medicare patients who were hospitalized with heart failure and who had a subsequent skilled nursing facility (SNF) stay of 30 days or less. Patients were categorized by their length of stay in the SNF and followed for the 30 days after their discharge from the SNF to home. Overall, nearly one-quarter of the SNF discharges to home were readmitted within the 30 day follow-up period. The rate of readmission was highest during the first two days home, but this risk was attenuated by a longer SNF length of stay. The authors conclude that interventions to reduce readmissions may be more effective if they incorporate patient transitions from SNF to home.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Li L, Bao H .
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
J Am Med Dir Assoc 2019 Apr;20(4):432-37. doi: 10.1016/j.jamda.2019.01.135..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Hospitalization, Nursing Homes
Shah S, Xian Y, Sheng S
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
This study examined the use, trends and outcomes of endovascular therapy (EVT) after interhospital transfer in the United Sates. This cohort study analyzed trends from over 1.8 million patients with ischemic stroke admitted to 2143 Get With The Guidelines-Stroke participating hospitals between 2012 and 2017. There were differences in mortality for interhospital transfer patients, although those differences disappeared after adjusting for delay in EVT initiation.
AHRQ-funded; HS024561.
Citation: Shah S, Xian Y, Sheng S .
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
Circulation 2019 Mar 26;139(13):1568-77. doi: 10.1161/circulationaha.118.036509..
Keywords: Stroke, Cardiovascular Conditions, Transitions of Care, Outcomes, Healthcare Delivery, Hospitals, Mortality, Quality of Care
Nuti SV, Li SX, Xu X
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
This study compared costs among Medicare fee-for-service beneficiaries aged 65 and over hospitalized with acute myocardial infarction (AMI) from 2010 to 2013 in the Premiere Healthcare Database. The association of in-hospital and post-acute care resource utilization and outcomes was examined. Researchers concluded that greater resource utilization during hospitalization was not associated with meaning differences in costs or mortality rates after hospitalization.
AHRQ-funded; HS023000.
Citation: Nuti SV, Li SX, Xu X .
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
BMC Health Serv Res 2019 Mar 25;19(1):190. doi: 10.1186/s12913-019-4018-0..
Keywords: Cardiovascular Conditions, Elderly, Healthcare Costs, Hospitalization, Medicare
Perry CK, Damschroder LJ, Hemler JR
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
This study used empirical data to test how the Expert Recommendations for Implementing Change (ERIC) taxonomy applies to a large dissemination and implementation initiative aimed at taking cardiac prevention to scale in primary care practice. The ERIC taxonomy was applied to the seven cooperatives funded by AHRQ’s EvidenceNOW initiative. The cooperatives' implementation strategies were identified using ERIC; a matrix of the specified ERIC strategies across the cooperatives was then mapped and compiled, and implementation strategies grouped according to outcomes and justifications. The findings suggest revisions to be made to the ERIC implementation strategies to reflect their utilization in real-work dissemination and implementation efforts.
AHRQ-funded; HS023940.
Citation: Perry CK, Damschroder LJ, Hemler JR .
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
Implement Sci 2019 Mar 21;14(1):32. doi: 10.1186/s13012-019-0876-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care, Implementation
Tracer H, Welch R
AHRQ Author: Tracer H
Screening for atrial fibrillation with electrocardiography.
This case study describes a 67-year-old woman with hypertension who neither drinks nor smokes and is moderately physically active. Her brother has recently been diagnosed with atrial fibrillation and she requests an electrocardiograph (ECG) to be screened herself for this condition. The case study questions are based on USPSTF recommendations for screening for atrial fibrillation with electrocardiography.
AHRQ-authored.
Citation: Tracer H, Welch R .
Screening for atrial fibrillation with electrocardiography.
Am Fam Physician 2019 Mar 15;99(6):383-84..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Screening, Prevention, Evidence-Based Practice, Case Study, Guidelines
Blecker S, Herrin J, Li L
Trends in hospital readmission of Medicare-covered patients with heart failure.
This study sought to compare trends in Medicare risk-adjusted, 30-day readmissions following principal heart failure (HF) hospitalizations and other hospitalizations with HF. The investigators found that patients with HF are often hospitalized for other causes, and these hospitalizations have high readmission rates. Policy changes led to decreases in readmission rates for both principal and secondary HF hospitalizations. Readmission rates in both groups remained high, suggesting that initiatives targeting all hospitalized patients with HF continue to be warranted.
AHRQ-funded; HS022882; HS023683.
Citation: Blecker S, Herrin J, Li L .
Trends in hospital readmission of Medicare-covered patients with heart failure.
J Am Coll Cardiol 2019 Mar 12;73(9):1004-12. doi: 10.1016/j.jacc.2018.12.040..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Hospitalization, Medicare, Policy
Khan NNS, Kelly-Blake K, Luo Z
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
The study’s purpose was to determine differences in the rate of statin prescribing by sex based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC/American Heart Association) cholesterol guidelines in Federally Qualified Health Centers (FQHCs). The study also wanted to determine adherence to those guidelines based on the 2013 recommendations. Two FQHCs were used and patients with coronary heart disease and diabetes mellitus (DM) were recruited. There was no difference between men and women in statin prescribing under ATPIII; however there was underprescribing for both men and women with atherosclerotic cardiovascular disease (ASCVD).
AHRQ-funded; HS018104.
Citation: Khan NNS, Kelly-Blake K, Luo Z .
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
Health Serv Res Manag Epidemiol 2019 Mar 5;6:2333392818825414. doi: 10.1177/2333392818825414..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Practice Patterns, Sex Factors
Inohara T, Kim S, Pieper K
B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation.
In this study, the investigators evaluated the association between B-type natriuretic peptide (BNP) levels and outcomes, including atrial fibrillation (AF) progression, composite outcome of major adverse cardiovascular or neurological events (MACNE) and major bleeding, via pooled logistic regression and Cox frailty models in Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry.
AHRQ-funded; HS021092.
Citation: Inohara T, Kim S, Pieper K .
B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation.
Heart 2019 Mar;105(5):370-77. doi: 10.1136/heartjnl-2018-313642..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Outcomes, Registries
Trent SA, Morse EA, Ginde AA
Barriers to prompt presentation to emergency departments in Colorado after onset of stroke symptoms.
Despite significant morbidity and mortality from stroke, patient delays to emergency department (ED) presentation following the onset of stroke symptoms are one of the main contraindications to treatment for acute ischemic stroke (AIS). The objective of this study was to identify patient and environmental factors associated with delayed presentations to the ED after onset of stroke symptoms.
AHRQ-funded; HS022400.
Citation: Trent SA, Morse EA, Ginde AA .
Barriers to prompt presentation to emergency departments in Colorado after onset of stroke symptoms.
West J Emerg Med 2019 Mar;20(2):237-43. doi: 10.5811/westjem.2018.10.38731..
Keywords: Emergency Department, Stroke, Cardiovascular Conditions, Healthcare Delivery
de Cordova PB, Johnansen ML, Riman KA
Public reporting of cardiac outcomes for patients with acute myocardial infarction: a systematic review of the evidence.
A systematic review was conducted to evaluate the effect of public reporting for patients with acute myocardial infarction (AMI), specifically for those patients who receive percutaneous coronary intervention (PCI). The investigators concluded that although public reporting may have had intentions of improving care, there was strong evidence that this policy did not result in more timely PCIs or improved mortality of patients with AMI. In fact, public reporting resulted in unintended consequences of not providing care for the most vulnerable patients in fear of an adverse outcome.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johnansen ML, Riman KA .
Public reporting of cardiac outcomes for patients with acute myocardial infarction: a systematic review of the evidence.
J Cardiovasc Nurs 2019 Mar/Apr;34(2):115-23. doi: 10.1097/jcn.0000000000000524..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery, Evidence-Based Practice
Huckfeldt P, Escarce J, Sood N
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
The goal of this cohort study was to determine whether short-term mortality rates increased among black and white adults 65 years and older after initiation of the Medicare Hospital Readmissions Reduction Program (HRRP) and whether trends differed by race. Using an interrupted time-series analysis, the researchers found that short-term post-discharge mortality did not appear to increase for black patients under the HRRP, suggesting that certain value-based payment policies can be implemented without harming black populations. However, mortality seemed to increase for white patients with heart failure; this situation warrants investigation.
AHRQ-funded; HS025394.
Citation: Huckfeldt P, Escarce J, Sood N .
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
JAMA Netw Open 2019 Mar;2(3):e190634. doi: 10.1001/jamanetworkopen.2019.0634..
Keywords: Medicare, Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Discharge
Morden NE, Woloshin S, Brooks CG
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
A study in 2010 (Basaria et al) revealed more cardiovascular events in men randomized to take testosterone than among men receiving a placebo. By 2015 the FDA had revised testosterone labels to highlight lack of efficacy evidence and possible increased cardiovascular risk. This study examines trends in testosterone use among Medicare-insured men over the age of 50 with and without coronary artery disease (CAD). A random sample was used of Medicare fee-for-service recipients from January 1, 2007 to December 31, 2016 using prescription fills under Medicare Parts B and D. Results showed that testosterone use was consistently higher among men with CAD than for men without CAD. Prescription rates had lowered after the warnings in 2013 but has remained higher than in 2007 and was largely off-label.
AHRQ-funded; HS024075.
Citation: Morden NE, Woloshin S, Brooks CG .
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
JAMA Intern Med 2019 Mar;179(3):446-48. doi: 10.1001/jamainternmed.2018.6505..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Men's Health, Medication
Gore MO, Krantz MJ, Albright K
A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program.
Researchers with the Colorado Healthy Heart Solutions (CHHS) program conducted a pilot trial to see determine if the use of mobile phone SMS (text messages) improves cardiovascular disease (CVD) risk profiles for the medically underserved population it serves. Results showed that for most outcomes there was no statistical significance between the intervention and control groups for all but self-reported fat intake.
AHRQ-funded.
Citation: Gore MO, Krantz MJ, Albright K .
A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program.
Prev Med Rep 2019 Mar;13:126-31. doi: 10.1016/j.pmedr.2018.11.021..
Keywords: Cardiovascular Conditions, Health Information Technology (HIT), Prevention, Rural Health
Kim D, Funk RJ, Yan P
Informal clinical integration in Medicare accountable care organizations and mortality following coronary artery bypass graft surgery.
Researchers looked at national Medicare data from 2008-2014 to determine if informal clinical integration in accountable care organizations (ACOs) made a difference in mortality rates in patients undergoing coronary artery bypass grafting (CABG). The cohort used were Medicare beneficiaries age 66 and older undergoing CABG. Results from ACO-participating health systems were compared with nonparticipating systems. Informal clinical integration made a difference in mortality, however there was no difference based on ACO participation for health systems on the low to moderate range.
AHRQ-funded; HS024525; HS024728.
Citation: Kim D, Funk RJ, Yan P .
Informal clinical integration in Medicare accountable care organizations and mortality following coronary artery bypass graft surgery.
Med Care 2019 Mar;57(3):194-201. doi: 10.1097/mlr.0000000000001052..
Keywords: Cardiovascular Conditions, Medicare, Mortality, Outcomes, Surgery