National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Antibiotics (2)
- Antimicrobial Stewardship (3)
- Breast Feeding (1)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Digestive Disease and Health (1)
- Evidence-Based Practice (2)
- Eye Disease and Health (2)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Costs (1)
- Hospitalization (1)
- Imaging (1)
- Infectious Diseases (2)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (1)
- Medication (3)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (5)
- (-) Newborns/Infants (17)
- Nutrition (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (4)
- Pregnancy (1)
- (-) Prevention (17)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Risk (1)
- Screening (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urinary Tract Infection (UTI) (2)
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
1 to 17 of 17 Research Studies DisplayedOke I, Lutz SM, Hunter DG
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
This research letter describes a cohort study that examined patterns and out-of-pocket costs of instrument-based vision screening among US children 12 to 36 months. The authors used 2018 MarketScan Commerical Claims and Encounters data as of January 1, 2018 and excluded those with fewer than 12 months of continuous insurance coverage, enrollment in capitated insurance plans, no preventive care encounters, or missing data on residents. The study included 246,077 children. Instrument-based vision screening was received by 19.5% (n = 48,101) of children during 2018. Median (IQR) practitioner payment for instrument-based vision screening claims was $13. Screening incurred out-of-pocket expenses for 7% of children; 30% of these children had expenses related to co-payment, 20.2% to coinsurance, and 50.7% to deductibles. Median (IQR) out-of-pocket expense was $11. Increased odds of vision screening were associated with older age, high-deductible plan enrollment, having more than 1 preventative visit, and receiving care within an area in the highest quartile of practitioner payment. This study was limited by use of commercial claims data, which excluded 45% of children with public or no coverage. Nationwide prevalence of vision screening therefore may differ for the general population.
AHRQ-funded; HS000063.
Citation: Oke I, Lutz SM, Hunter DG .
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
JAMA Pediatr 2023 Jul; 177(7):728-30. doi: 10.1001/jamapediatrics.2023.0808..
Keywords: Newborns/Infants, Eye Disease and Health, Screening, Prevention, Healthcare Costs
Weiss AB, Newnam KW, Wyles C
Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens.
AHRQ-funded; HS022908.
Citation: Weiss AB, Newnam KW, Wyles C .
Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens.
Adv Neonatal Care 2021 Dec 1;21(6):462-72. doi: 10.1097/anc.0000000000000966..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Prevention
Milstone AM, Voskertchian A, Koontz DW
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
This study examined the effect of treating parents of neonates in the intensive care unit (NICUs) with intranasal mupirocin and topical chlorhexidine compared with a placebo treatment and whether it reduces transmission of Staphlyococcus aureus to their babies. A double-blind randomized trial was conducted at 2 tertiary NICUs in Baltimore, MD from November 2014 to December 2018. Parents were given intranasal treatments for 5 days. Of the intervention group 13 of 89 neonates acquired S aureus, and in the control group 29 of 101 neonates acquired S aureus with the same strain as their parents. The results showed a significant reduction in transmission.
AHRQ-funded; HS022872.
Citation: Milstone AM, Voskertchian A, Koontz DW .
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
JAMA 2020 Jan;323(4):295-386. doi: 10.1001/jama.2019.20785..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Stoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Gephart SM, Quinn MC
Relationship of necrotizing enterocolitis rates to adoption of prevention practices in US neonatal intensive care units.
Applying quality improvement methods has reduced necrotizing enterocolitis (NEC) in some neonatal intensive care units (NICUs) by 40% to 90%. This study was conducted to (1) examine relationships between adoption of prevention practices using the NEC-Zero adherence score and NEC rates, and (2) describe implementation strategies NICUs use to prevent NEC. The investigators concluded that broader use of evidence-based implementation strategies could bolster delivery of NEC prevention practices. The indicated that maternal lactation support is paramount.
AHRQ-funded; HS022908.
Citation: Gephart SM, Quinn MC .
Relationship of necrotizing enterocolitis rates to adoption of prevention practices in US neonatal intensive care units.
Adv Neonatal Care 2019 Aug;19(4):321-32. doi: 10.1097/anc.0000000000000592..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Prevention
Wang HH, Kurtz M, Logvinenko T
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
The RIVUR (Randomized Intervention for Children with Vesicoureteral Reflux) trial reported that antibiotic prophylaxis reduced recurrent urinary tract infection but antibiotic prophylaxis was not associated with decreased new renal scarring. However, the original reports did not assess the relationship among recurrent urinary tract infection, new renal scarring and antibiotic prophylaxis in detail. Therefore, this study investigated the relationship among these issues.
AHRQ-funded; HS000063.
Citation: Wang HH, Kurtz M, Logvinenko T .
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
J Urol 2019 Aug;202(2):400-05. doi: 10.1097/ju.0000000000000292..
Keywords: Newborns/Infants, Urinary Tract Infection (UTI), Antibiotics, Medication, Prevention
Guirguis-Blake JM, Evans CV, Rushkin M
Ocular prophylaxis for gonococcal ophthalmia neonatorum: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review was commissioned for the U.S. Preventive Services Task Force to update the evidence of using prophylactic ocular topic medication for all newborns to prevent gonococcal ophthalmia neonatorum (GON) which can cause blindness if not treated immediately. Many articles were screened for inclusion, and of those included the recommendations remained an “A” grade recommendation, which is to apply the topical medication on all newborns due to an increase in syphilis prevalence.
AHRQ-funded; 290201500007I.
Citation: Guirguis-Blake JM, Evans CV, Rushkin M .
Ocular prophylaxis for gonococcal ophthalmia neonatorum: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Jan 29;321(4):404-06. doi: 10.1001/jama.2018.17847..
Keywords: Evidence-Based Practice, Eye Disease and Health, Guidelines, Newborns/Infants, Prevention, U.S. Preventive Services Task Force (USPSTF)
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Khamash DF, Voskertchian A, Milstone AM
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
Hospitalized infants have the highest rates of invasive Staphylococcus aureus disease of any population and infection control strategies such as decolonization have been insufficient. In this article, the authors review what is known about bacterial communities in the nasal cavity of infants and discuss how future microbiome studies may help identify novel interventions to protect high-risk infants from S. aureus disease.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Milstone AM .
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
J Perinatol 2018 Feb;38(2):105-09. doi: 10.1038/jp.2017.155..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Children/Adolescents, Prevention, Newborns/Infants, Patient Safety
Gephart SM, Hanson C, Wetzel CM
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
The purpose of this paper is to present a scoping review with two new meta-analyses, clinical recommendations, and implementation strategies to prevent and foster timely recognition of necrotizing enterocolitis. The researchers conducted a stakeholder-engaged scoping review to classify strength of evidence and form implementation recommendations across subgroup areas: 1) promoting human milk, 2) feeding protocols and transfusion, 3) timely recognition strategies, and 4) medication stewardship.
AHRQ-funded; HS022908.
Citation: Gephart SM, Hanson C, Wetzel CM .
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
Matern Health Neonatol Perinatol 2017 Dec;3:23. doi: 10.1186/s40748-017-0062-0.
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Keywords: Adverse Events, Digestive Disease and Health, Guidelines, Newborns/Infants, Prevention
Abrams EM, Greenhawt M, Fleischer DM
Early solid food introduction: role in food allergy prevention and implications for breastfeeding.
The authors explore the evidence suggesting that introduction of solid foods before age 6 months might reduce the risk of food allergy. In addition, they review the possible implications of earlier solid food introduction on both the benefits of exclusive breastfeeding and the total duration of breastfeeding. Finally, they argue that harmonization of early introduction guidelines with breastfeeding guidelines is needed to maximize the benefits of both exclusive breastfeeding and early complementary food introduction
AHRQ-funded; HS024599.
Citation: Abrams EM, Greenhawt M, Fleischer DM .
Early solid food introduction: role in food allergy prevention and implications for breastfeeding.
J Pediatr 2017 May;184:13-18. doi: 10.1016/j.jpeds.2017.01.053.
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Keywords: Breast Feeding, Newborns/Infants, Newborns/Infants, Nutrition, Prevention
Travers CP, Carlo WA
How to save 1 million lives in a year in low- and middle-income countries.
This review focuses on educational programs developed to reduce preventable deaths in newborn infants in low- and middle-income countries, including Essential Newborn Care and Helping Babies Breathe, a simplified version of the Neonatal Resuscitation Program. Innovative pragmatic large-scale trials have evaluated these programs in low-resource settings. The results of these studies and the implications for future programs designed to decrease childhood mortality are reviewed.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA .
How to save 1 million lives in a year in low- and middle-income countries.
Neonatology 2017;111(4):431-36. doi: 10.1159/000460512.
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Keywords: Newborns/Infants, Mortality, Newborns/Infants, Pregnancy, Prevention
Pierce R, Lessler J, Popoola VO
Meticillin-resistant Staphylococcus aureus (MRSA) acquisition risk in an endemic neonatal intensive care unit with an active surveillance culture and decolonization programme.
The researchers measured the association between colonization pressure from decolonized and non-decolonized neonates and methicillin-resistant staphylococcus aureus (MRSA) and MRSA acquisition to inform use of this strategy for control of endemic MRSA. They concluded that untreated MRSA carriers were an important reservoir for transmission. Decolonized patients on contact isolation posed no detectable transmission threat, supporting the hypothesis that decolonization may reduce patient-to-patient transmission.
AHRQ-funded; HS022872.
Citation: Pierce R, Lessler J, Popoola VO .
Meticillin-resistant Staphylococcus aureus (MRSA) acquisition risk in an endemic neonatal intensive care unit with an active surveillance culture and decolonization programme.
J Hosp Infect 2017 Jan;95(1):91-97. doi: 10.1016/j.jhin.2016.10.022.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Neonatal Intensive Care Unit (NICU), Prevention, Newborns/Infants
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)
Milstone AM, Koontz DW, Voskertchian A
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
This study looks to measure the effect of treating parents with short course intranasal mupirocin and topical chlorhexidine antisepsis on acquisition of S. aureus colonisation and infection in neonates. The primary outcome will be neonatal acquisition of an S. aureus strain that is concordant to the parental baseline S. aureus strain.
AHRQ-funded; HS022872.
Citation: Milstone AM, Koontz DW, Voskertchian A .
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
BMJ Open 2015 Sep 09;5(9):e009274. doi: 10.1136/bmjopen-2015-009274.
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Keywords: Healthcare-Associated Infections (HAIs), Newborns/Infants, Antimicrobial Stewardship, Prevention, Neonatal Intensive Care Unit (NICU)
Ho T, Dukhovny D, Zupancic JA
Choosing Wisely in newborn medicine: five opportunities to increase value.
This report describes the identification of 5 tests and treatments in newborn medicine. The expert panel achieved consensus on the top 5 items. The first item was to avoid routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux disease or for treatment of apnea and desaturation in preterm infants.
AHRQ-funded; HS000063.
Citation: Ho T, Dukhovny D, Zupancic JA .
Choosing Wisely in newborn medicine: five opportunities to increase value.
Pediatrics 2015 Aug;136(2):e482-9. doi: 10.1542/peds.2015-0737..
Keywords: Newborns/Infants, Prevention, Patient-Centered Outcomes Research, Guidelines