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
1 to 12 of 12 Research Studies DisplayedIantorno SE, Scaife JH, Bryce JR
Emergency department utilization for pediatric gastrostomy tubes across the United States.
This study investigated the number and nature of emergency department (ED) visits to community hospitals for pediatric gastrostomy tube complication. The authors used the 2019 Nationwide Emergency Department Sample to perform a retrospective cross-sectional analysis of pediatric patients (<18 y) with a primary diagnosis of gastrostomy tube complication. Their primary outcome was a potentially preventable ED visit, defined as an encounter that did not result in any imaging, procedures, or an inpatient admission. They observed 32,036 ED visits at 535 hospitals and 15,165 (47.3%) were potentially preventable. Median age was 2 years, and 17,707 (55%) were male. Compared to White patients, patients with higher odds of potentially preventable visits were Black and Hispanic. Patients with residential zip codes in the first, second, and third median household income quartiles had higher odds of potentially preventable visits compared to the highest.
AHRQ-funded; HS025776.
Citation: Iantorno SE, Scaife JH, Bryce JR .
Emergency department utilization for pediatric gastrostomy tubes across the United States.
J Surg Res 2024 Mar; 295:820-26. doi: 10.1016/j.jss.2023.11.028.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Healthcare Utilization, Surgery, Adverse Events
Hoffmann JA, Carter CP, Olsen CS
Pediatric firearm injury emergency department visits from 2017 to 2022: a multicenter study.
This retrospective study aimed to assess how pediatric firearm injury emergency department (ED) visits during the pandemic differed from expected prepandemic trends. The authors looked at firearm injury ED visits by children <18 years old at 9 US hospitals participating in the Pediatric Emergency Care Applied Research Network Registry before (January 2017 to February 2020) and during (March 2020 to November 2022) the pandemic. They calculated rate ratios (RRs) of observed to expected visits per 30 days, overall, and by sociodemographic characteristics. They identified 1904 firearm injury ED visits (52.3% 15-17 years old, 80.0% male, 63.5% non-Hispanic Black), with 694 prepandemic visits and 1210 visits during the pandemic. Death in the ED/hospital increased from 3.1% prepandemic to 6.1% during the pandemic. Firearm injury visits per 30 days increased from 18.0 prepandemic to 36.1 during the pandemic (RR 2.09). Increases beyond expected rates were seen for 10- to 14-year-olds (RR 2.61), females (RR 2.46), males (RR 2.00), Hispanic children (RR 2.30), and Black non-Hispanic children (RR 1.88).
AHRQ-funded; R01HS020270.
Citation: Hoffmann JA, Carter CP, Olsen CS .
Pediatric firearm injury emergency department visits from 2017 to 2022: a multicenter study.
Pediatrics 2023 Dec; 152(6). doi: 10.1542/peds.2023-063129..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Injuries and Wounds
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Bardach NS, Harder VS, McCulloch CE
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Researchers sought to assess the association between follow-up after an asthma-related emergency department (ED) visit and the likelihood of subsequent asthma-related ED utilization. Using data from California Medicaid, Vermont, and Massachusetts all-payer claims databases, they found a protective association between outpatient 14-day follow-up and asthma-related ED revisits. They suggested that this may reflect improved asthma control as providers follow the NHLBI guideline stepwise approach.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Harder VS, McCulloch CE .
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Acad Pediatr 2022 Apr;22(3S):S125-S32. doi: 10.1016/j.acap.2021.10.015..
Keywords: Children/Adolescents, Asthma, Emergency Department, Respiratory Conditions, Healthcare Utilization
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Hoffmann JA, Hall M, Lorenz D
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
The authors sought to compare emergency department (ED) visit rates for suicidal ideation and/or self-harm among youth by urban-rural location of residence. Data was taken from the Nationwide Emergency Department Sample. They found that, compared with youths living in urban areas, youths living in rural areas had higher ED visit rates for self-harm, including self-inflicted firearm injuries. The researchers recommended preventive approaches for self-harm based in community and ED settings in order to help address these differences.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Hall M, Lorenz D .
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
J Pediatr 2021 Nov;238:282-89.e1. doi: 10.1016/j.jpeds.2021.07.013..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Behavioral Health, Rural Health, Urban Health, Healthcare Utilization
Ramgopal S, Aronson PL, Marin JR
United States' emergency department visits for fever by young children 2007-2017.
The authors estimated rates of emergency department (ED) visits for fever by children less than 2 years of age and evaluated frequencies of testing and treatment during these visits. They found that, given existing guidelines, blood and urine culture performance was low for infants up to 90 days old. For children 91 days up to 2 years, rates of radiography and antibiotic use were higher in general EDs compared to pediatric EDs. They concluded that their findings suggest opportunities to improve care among febrile young children in the ED.
AHRQ-funded; HS026006.
Citation: Ramgopal S, Aronson PL, Marin JR .
United States' emergency department visits for fever by young children 2007-2017.
West J Emerg Med 2020 Oct 27;21(6):146-51. doi: 10.5811/westjem.2020.8.47455..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Arthur KC, Mangione-Smith R, Burkhart Q
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
The objective of this study was to examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. The investigators measured ED utilization and primary care continuity with the Bice-Boxerman continuity of care index for 1477 CMC using administrative data from Minnesota and Washington state Medicaid agencies. They concluded that continuity of care holds promise as a quality measure for CMC because of its association with lower ED utilization and more frequent receipt of care coordination.
AHRQ-funded; HS020506.
Citation: Arthur KC, Mangione-Smith R, Burkhart Q .
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
Acad Pediatr 2018 Aug;18(6):669-76. doi: 10.1016/j.acap.2018.04.009..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Emergency Department, Healthcare Utilization, Primary Care, Quality of Care, Quality Indicators (QIs), Quality Measures
Arthur KC, Lucenko BA, Sharkova IV
Using state administrative data to identify social complexity risk factors for children.
Researchers aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examine their relationship to emergency department (ED) use. They concluded that State administrative data can be used to identify social complexity risk factors associated with higher rates of ED use among Medicaid-insured children.
AHRQ-funded; HS020506.
Citation: Arthur KC, Lucenko BA, Sharkova IV .
Using state administrative data to identify social complexity risk factors for children.
Ann Fam Med 2018 Jan;16(1):62-69. doi: 10.1370/afm.2134.
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Keywords: Children/Adolescents, Data, Emergency Department, Healthcare Utilization, Risk
Aalsma MC, Anderson VR, Schwartz K
Preventive care use among justice-involved and non-justice-involved youth.
The objective of this study was to determine how rates of well-child (WC) and emergency department visits, as well as public insurance enrollment continuity, differed between youth involved in the justice system (JIY) and youth who have never been in the system (NJIY). It found that JIY had lower use rates of WC visits and higher use rates of emergency services in comparison with NJIY. JIY had more and longer gaps in Medicaid coverage compared with NJIY.
AHRQ-funded; HS023318.
Citation: Aalsma MC, Anderson VR, Schwartz K .
Preventive care use among justice-involved and non-justice-involved youth.
Pediatrics 2017 Nov;140(5):pii: e20171107. doi: 10.1542/peds.2017-1107.
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Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Medicaid