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 (12)
- Adverse Drug Events (ADE) (9)
- Adverse Events (71)
- Alcohol Use (4)
- Ambulatory Care and Surgery (8)
- Antibiotics (7)
- Antimicrobial Stewardship (2)
- Anxiety (2)
- Arthritis (19)
- Asthma (9)
- Autism (1)
- Back Health and Pain (10)
- Behavioral Health (33)
- Blood Clots (3)
- Blood Pressure (6)
- Blood Thinners (11)
- Brain Injury (10)
- Breast Feeding (2)
- Cancer (68)
- Cancer: Breast Cancer (7)
- Cancer: Colorectal Cancer (4)
- Cancer: Lung Cancer (13)
- Cancer: Prostate Cancer (14)
- Cardiovascular Conditions (111)
- Care Coordination (4)
- Caregiving (2)
- Care Management (22)
- Case Study (4)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (72)
- Chronic Conditions (44)
- Clinical Decision Support (CDS) (4)
- Clinician-Patient Communication (2)
- Clostridium difficile Infections (1)
- Communication (7)
- Community-Acquired Infections (5)
- Community-Based Practice (5)
- Comparative Effectiveness (120)
- Complementary and Alternative Medicine (3)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- COVID-19 (13)
- Critical Care (19)
- Cultural Competence (2)
- Data (8)
- Dementia (2)
- Dental and Oral Health (1)
- Depression (16)
- Diabetes (19)
- Diagnostic Safety and Quality (10)
- Dialysis (6)
- Digestive Disease and Health (14)
- Disabilities (5)
- Disparities (22)
- Education (1)
- Education: Continuing Medical Education (6)
- Education: Patient and Caregiver (3)
- Elderly (78)
- Electronic Health Records (EHRs) (13)
- Emergency Department (31)
- Emergency Medical Services (EMS) (8)
- Evidence-Based Practice (144)
- Eye Disease and Health (1)
- Falls (2)
- Family Health and History (2)
- Guidelines (10)
- Healthcare-Associated Infections (HAIs) (9)
- Healthcare Cost and Utilization Project (HCUP) (32)
- Healthcare Costs (26)
- Healthcare Delivery (18)
- Healthcare Utilization (21)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (42)
- Health Insurance (14)
- Health Literacy (4)
- Health Services Research (HSR) (11)
- Health Status (10)
- Health Systems (2)
- Heart Disease and Health (66)
- Hepatitis (3)
- Home Healthcare (2)
- Hospital Discharge (14)
- Hospitalization (36)
- Hospital Readmissions (34)
- Hospitals (56)
- Human Immunodeficiency Virus (HIV) (14)
- Imaging (7)
- Implementation (3)
- Infectious Diseases (6)
- Influenza (2)
- Injuries and Wounds (23)
- Inpatient Care (19)
- Intensive Care Unit (ICU) (28)
- Kidney Disease and Health (30)
- Labor and Delivery (18)
- Learning Health Systems (3)
- Lifestyle Changes (4)
- Long-Term Care (7)
- Low-Income (8)
- Maternal Care (16)
- Medicaid (13)
- Medical Devices (10)
- Medicare (46)
- Medication (91)
- Medication: Safety (4)
- Men's Health (5)
- Mortality (92)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (20)
- Newborns/Infants (30)
- Nursing (4)
- Nursing Homes (16)
- Nutrition (9)
- Obesity (24)
- Obesity: Weight Management (14)
- Opioids (9)
- Orthopedics (19)
- Osteoporosis (1)
- (-) Outcomes (805)
- Pain (20)
- Palliative Care (6)
- Patient-Centered Healthcare (14)
- Patient-Centered Outcomes Research (272)
- Patient Adherence/Compliance (5)
- Patient and Family Engagement (2)
- Patient Experience (8)
- Patient Safety (54)
- Patient Self-Management (2)
- Payment (3)
- Pneumonia (8)
- Policy (7)
- Practice Patterns (10)
- Pregnancy (24)
- Pressure Ulcers (1)
- Prevention (19)
- Primary Care (12)
- Primary Care: Models of Care (1)
- Provider (5)
- Provider: Health Personnel (2)
- Provider: Nurse (3)
- Provider: Physician (7)
- Provider Performance (14)
- Public Health (3)
- Public Reporting (7)
- Quality Improvement (45)
- Quality Indicators (QIs) (11)
- Quality Measures (17)
- Quality of Care (72)
- Quality of Life (31)
- Racial and Ethnic Minorities (35)
- Registries (30)
- Rehabilitation (10)
- Research Methodologies (21)
- Respiratory Conditions (39)
- Risk (59)
- Rural Health (7)
- Screening (2)
- Sepsis (26)
- Sex Factors (15)
- Sexual Health (2)
- Shared Decision Making (14)
- Sickle Cell Disease (3)
- Simulation (1)
- Skin Conditions (6)
- Sleep Problems (3)
- Social Determinants of Health (18)
- Stress (4)
- Stroke (27)
- Substance Abuse (9)
- Surgery (216)
- Surveys on Patient Safety Culture (2)
- Teams (10)
- TeamSTEPPS (1)
- Telehealth (13)
- Tobacco Use (7)
- Tools & Toolkits (2)
- Training (5)
- Transitions of Care (9)
- Transplantation (23)
- Trauma (12)
- Treatments (35)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Uninsured (2)
- Urban Health (3)
- Urinary Tract Infection (UTI) (2)
- Vaccination (1)
- Vulnerable Populations (4)
- Web-Based (1)
- Women (38)
- Workforce (3)
- Young Adults (2)
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
101 to 125 of 805 Research Studies DisplayedWeekes AJ, Raper JD, Lupez K
Development and validation of a prognostic tool: pulmonary embolism short-term clinical outcomes risk estimation (PE-SCORE).
The objective of this study was to develop and validate a prognostic model for clinical deterioration or death within days of pulmonary embolism (PE) diagnosis using point-of-care criteria. In this study, the investigators used prospective registry data from six emergency departments. The primary composite outcome was death or deterioration (respiratory failure, cardiac arrest, new dysrhythmia, sustained hypotension, and rescue reperfusion intervention) within 5 days.
AHRQ-funded; HS025979.
Citation: Weekes AJ, Raper JD, Lupez K .
Development and validation of a prognostic tool: pulmonary embolism short-term clinical outcomes risk estimation (PE-SCORE).
PLoS One 2021 Nov 18;16(11):e0260036. doi: 10.1371/journal.pone.0260036..
Keywords: Respiratory Conditions, Risk, Outcomes
Greenwood-Ericksen M, Kamdar N, Lin P
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
This study compared 30-day mortality rates after emergency department (ED) visits to rural or critical access hospitals (CAHs) compared to urban hospitals for Medicare beneficiaries. A 20% sample of Medicare beneficiaries was used from January 2011 to October 31, 2015. The primary outcome measured was 30-day mortality. Secondary outcome examined was ED visits with and without rehospitalization. Mortality rates were comparable with both groups, although patients in rural EDs experienced more transfers and less hospitalization.
AHRQ-funded; HS024160.
Citation: Greenwood-Ericksen M, Kamdar N, Lin P .
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
JAMA Netw Open 2021 Nov;4(11):e2134980. doi: 10.1001/jamanetworkopen.2021.34980..
Keywords: Hospitals, Rural Health, Urban Health, Emergency Department, Mortality, Outcomes
Jiang DH, Mundell BF, Shah ND
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
The authors sought to provide a systematic literature review of the impact of high deductible health plans (HDHPs) on the utilizations of services required for optimal management of diabetes and subsequent health outcomes. They found that, although HDHPs reduce some health care utilization and costs, they appear to do so at the expense of limiting high-value care and medication adherence.
AHRQ-funded; HS025517; HS024075; HS025164; HS025402.
Citation: Jiang DH, Mundell BF, Shah ND .
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
Endocr Pract 2021 Nov;27(11):1156-64. doi: 10.1016/j.eprac.2021.07.001..
Keywords: Health Insurance, Diabetes, Chronic Conditions, Outcomes, Quality of Care, Patient-Centered Outcomes Research
Delaney LD, Howard R, Palazzolo K
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
The authors evaluated the feasibility of evidence-based patient optimization before surgery by implementing a low-cost preoperative optimization clinic. They found that a hernia optimization clinic safely improved management of high-risk patients and increased operative yield for the institution. They concluded that their results represented an opportunity to create sustainable and scalable models that provide longitudinal care and optimize patients to improve outcomes of hernia repair.
AHRQ-funded; HS025778.
Citation: Delaney LD, Howard R, Palazzolo K .
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
JAMA Netw Open 2021 Nov;4(11):e2130016. doi: 10.1001/jamanetworkopen.2021.30016..
Keywords: Surgery, Risk, Evidence-Based Practice, Quality Improvement, Quality of Care, Outcomes
Czosek RJ, Anderson JB, Baskar S
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
This study investigated patient and surgical risks of heart block and its effect on 12-month transplant-free survival in children with a single ventricle. In total, 1423 patients were identified from the National Pediatric Cardiology Improvement Collaborative with and without heart block. One-year outcomes were analyzed. A very small percentage (2%) developed heart block during their surgical admission. Associated risk factors for block included heterotaxy syndrome and atrial flutter/fibrillation. Patients with complete heart block had lower 12-month survival, which wasn’t true for patients with second degree block. At 12 months of age, 43% of patients with heart block died and were more likely to experience mortality than patients without heart block.
AHRQ-funded; HS021114.
Citation: Czosek RJ, Anderson JB, Baskar S .
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
Heart Rhythm 2021 Nov;18(11):1876-83. doi: 10.1016/j.hrthm.2021.05.019..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Surgery, Palliative Care, Risk, Outcomes
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation: Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords: Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Kaufmann TL, Getz KD, Hsu JY
Identification of patient-reported outcome phenotypes among oncology patients with palliative care needs.
This retrospective study used patient-reported outcome (PRO) data to characterize oncology patients with palliative care needs. The objective was to determine if PRO data can identify latent phenotypes that characterize indications for specialty palliative care referral. Self-reported symptoms were collected on the Edmonton Symptom Assessment Symptom from solid tumor oncology patients (n = 745) referred to outpatient palliative care at eight community and academic sites from October 2012 to October 2018. The authors identified four PRO phenotypes: low symptoms (39.6%); moderate pain/fatigue + mood (24.2%); moderate pain/fatigue + appetite + dypsnea (27%); and high symptoms (9.3%). A secondary analysis of 421 patients found that two brief items assessing social and existential needs aligned with higher severity symptoms and psychological distress phenotypes.
AHRQ-funded; HS023681.
Citation: Kaufmann TL, Getz KD, Hsu JY .
Identification of patient-reported outcome phenotypes among oncology patients with palliative care needs.
JCO Oncol Pract 2021 Oct;17(10):e1473-e88. doi: 10.1200/op.20.00849..
Keywords: Cancer, Palliative Care, Patient-Centered Outcomes Research, Outcomes
Cardell CF, Knapp L, Cohen ME
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
This study looked at the results of a national colorectal enhanced recovery program (ERP) to improve patient outcomes. A total of 207 hospitals participated between 2017 and 2020. Quantitative (patient-level process and outcome) and qualitative (survey and structured interviews with hospital teams) data were collected and analyzed. Results shows that 62 hospitals were characterized as High Performance, and 52 as High Improvement. High Performance hospitals were larger with more annual colorectal surgeries. Fewer barriers to staff-buy-in and competing priorities, and more experience with standardized perioperative care were also characteristics of High Performance hospitals. High Improvement hospitals had lower baseline process measure (PM) adherence and less experience with perioperative care but had positive trends in annual patient outcomes such as annual morbidity, readmission, and prolonged length of stay compared to Low Improvement Hospitals.
AHRQ-funded; 233201500020I.
Citation: Cardell CF, Knapp L, Cohen ME .
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
Ann Surg 2021 Oct 1;274(4):605-12. doi: 10.1097/sla.0000000000005069..
Keywords: Surgery, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Mathis MR, Yule S, Wu X
The impact of team familiarity on intra and postoperative cardiac surgical outcomes.
The authors hypothesized that familiarity among cardiac surgery team members may be an important contributor to better outcomes and thus serve as a target for enhancing outcomes. They found that high team familiarity was associated with reduced cardiopulmonary bypass duration for medium-risk and high-risk patients. Increasing team familiarity was not significantly associated with the odds of major morbidity and mortality. They concluded that team familiarity, which was predictive of improved intraoperative efficiency without compromising major postoperative outcomes, may serve as a novel quality improvement target in the setting of cardiac surgery.
AHRQ-funded; HS026003.
Citation: Mathis MR, Yule S, Wu X .
The impact of team familiarity on intra and postoperative cardiac surgical outcomes.
Surgery 2021 Oct;170(4):1031-38. doi: 10.1016/j.surg.2021.05.020..
Keywords: Teams, Surgery, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Jacobs M, Ellis C
Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
This study assessed the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia. Twenty persons with aphasia completed between 5 and 12 telehealth sessions of 45-60 minutes within a 6-week timeframe using a Language-Oriented Treatment (LOT). Measures were used to obtain baseline and treatment status using the National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL). African Americans were twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increased with each additional year of education but decreased with age. The average cost of treatment varied between $540 and $1,296. However, on average the monetary equivalent in patient’s improved QCL was between $1,790 to $3,912, showing the QCL far exceeded the financial cost of treatment.
AHRQ-funded; HS025043.
Citation: Jacobs M, Ellis C .
Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
PLoS One 2021 Sep 17;16(9):e0257462. doi: 10.1371/journal.pone.0257462..
Keywords: Telehealth, Health Information Technology (HIT), Healthcare Costs, Outcomes
Kwee Wong, LL Sato, MM
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
This study’s objective was to compare overall survival (OS) rates for hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI) for patients undergoing either transarterial radioembolization (TARE) or systemic therapy. The National Cancer Database was used to identify 1,514 patients with HCC-MVI. TARE use had doubled between 2010 and 2015. OS was compared for the two treatments and TARE was found to be associated with significant survival benefits compared with systemic therapy.
AHRQ-funded; HS023185.
Citation: Kwee Wong, LL Sato, MM .
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
J Vasc Interv Radiol 2021 Sep;32(9):1258-66.e6. doi: 10.1016/j.jvir.2021.07.001..
Keywords: Cancer, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Stevens JP, Dechen T, Schwartzstein RM
Association of dyspnoea, mortality and resource use in hospitalised patients.
As many as one in 10 patients experience dyspnoea at hospital admission but the relationship between dyspnoea and patient outcomes is unknown. In this study, the investigators sought to determine whether dyspnoea on admission predicts outcomes. They conducted a retrospective cohort study in a single, academic medical centre. They analysed 67 362 consecutive hospital admissions with available data on dyspnoea, pain and outcomes.
AHRQ-funded; HS024288.
Citation: Stevens JP, Dechen T, Schwartzstein RM .
Association of dyspnoea, mortality and resource use in hospitalised patients.
Eur Respir J 2021 Sep 2;58(3). doi: 10.1183/13993003.02107-2019..
Keywords: Respiratory Conditions, Mortality, Outcomes
Fredericksen RJ, Harding BN, Ruderman SA
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
The authors assessed acceptability/usability of tablet-based patient-reported outcome (PRO) assessments among patients in HIV care and relationships with health outcomes using a modified Acceptability E-Scale (AES) within a self-administered PRO assessment. They found that higher acceptability was associated with better quality of life and adherence while lower acceptability was associated with higher depression symptoms, recent illicit opioid use, and multiple recent sex partners. While patients endorsing depression symptoms, recent opioid use, sex without condoms, or multiple sex partners found PROs less acceptable, overall, patients found the assessments highly acceptable and easy to use.
AHRQ-funded; HS026154.
Citation: Fredericksen RJ, Harding BN, Ruderman SA .
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
AIDS Care 2021 Sep;33(9):1167-77. doi: 10.1080/09540121.2020.1845288..
Keywords: Human Immunodeficiency Virus (HIV), Quality of Life, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Adams LB, Richmond J, Watson SN
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
This systematic review examined research on the relationship between community health worker (CHW) training curricula and intervention outcomes conducted among African American and Latinx populations. Studies included were quantitative, qualitative, and mixed methods studies employed to conduct outcome and process evaluations of CHW-led interventions. Out of 3,295 articles from the extensive literature search, only 36 met the review’s inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary health interventions in conditions such as hypertension and diabetes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that discussed training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training methods.
AHRQ-funded; HS000032; HS026122.
Citation: Adams LB, Richmond J, Watson SN .
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
Health Educ Behav 2021 Aug;48(4):516-31. doi: 10.1177/1090198120959326..
Keywords: Community-Based Practice, Racial and Ethnic Minorities, Training, Outcomes, Provider: Health Personnel
Howard R, Johnson E, Berlin NL
Hospital and surgeon variation in 30-day complication rates after ventral hernia repair.
Researchers analyzed variability in 30-day complication rates and identified specific complications that contributed to this variability after ventral hernia repair. They found that, after adjusting for a number of patient-specific clinical variables, there was significant variation in 30-day complication rates after ventral hernia repair, representing a significant opportunity to improve patient outcomes.
AHRQ-funded; HS025778.
Citation: Howard R, Johnson E, Berlin NL .
Hospital and surgeon variation in 30-day complication rates after ventral hernia repair.
Am J Surg 2021 Aug;222(2):417-23. doi: 10.1016/j.amjsurg.2020.12.021..
Keywords: Surgery, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Klein IA, Rosenberg SM, Reynolds KL
Impact of cancer history on outcomes among hospitalized patients with COVID-19.
Researchers investigated whether a current cancer diagnosis or cancer history is an independent risk factor for death in hospitalized patients with COVID-19. They found that patients with a history of cancer hospitalized for COVID-19 had similar mortality to matched hospitalized patients with COVID-19 without cancer, and a lower risk of complications, while patients with active cancer or recent cancer treatment had a similar risk for adverse outcomes compared with survivors of cancer. They concluded that active cancer, systemic cancer therapy, and a cancer history are not independent risk factors for death from COVID-19 among hospitalized patients, and hospitalized patients without cancer are more likely to have severe COVID-19.
AHRQ-funded; HS023680.
Citation: Klein IA, Rosenberg SM, Reynolds KL .
Impact of cancer history on outcomes among hospitalized patients with COVID-19.
Oncologist 2021 Aug;26(8):685-93. doi: 10.1002/onco.13794..
Keywords: COVID-19, Cancer, Risk, Mortality, Hospitalization, Outcomes
Silverberg JI, Lai Cella, D D
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
The Patient-Reported Outcomes Measurement Information System Itch Questionnaire (PIQ), includes a suite of patient-reported outcome measures to assess the burden of itch in adults. In this study, the investigators sought to determine the smallest detectable change (SDC), threshold for meaningful improvement and test–retest reliability of PIQ item banks for assessing the burden of itch in adult AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lai Cella, D D .
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
Br J Dermatol 2021 Aug;185(2):438-39. doi: 10.1111/bjd.20066..
Keywords: Skin Conditions, Patient-Centered Outcomes Research, Outcomes, Diagnostic Safety and Quality
Delaney LD, Kattapuram M, Haidar JA
The impact of surgeon adherence to preoperative optimization of hernia repairs.
This study looked at the ways that surgeon-level adherence to preoperative optimization impacts postoperative outcomes. A cohort of patients receiving hernia repair surgery were studied using data from the Michigan Surgical Quality Collaborative from 2014 to 2018. Adherence to preoperative optimization was defined as operating on patients who were nontobacco users with a body mass index of >18.5 kg/m2 and <40 kg/m2. Risk- and reliability-adjusted adherence rates were used to divide surgeons into tertiles. Across 70 Michigan hospitals, 15,016 patients underwent ventral and incisional hernia repair, cared for by 454 surgeons. Preoperative optimization rates ranged from 51% to 76%. Surgeons in the lowest tertile had higher rates of emergency department visits and serious complications versus any complication than middle and high optimization tertiles.
AHRQ-funded; HS025778.
Citation: Delaney LD, Kattapuram M, Haidar JA .
The impact of surgeon adherence to preoperative optimization of hernia repairs.
J Surg Res 2021 Aug;264:8-15. doi: 10.1016/j.jss.2021.01.044..
Keywords: Surgery, Provider: Physician, Provider, Outcomes
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Richardson DR, Oakes AH, Crossnohere NL
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Although patients with acute myeloid leukemia (AML) experience significant toxicities and poor outcomes, few studies have quantified patients' experience. In this study, a community-centered approach was used to develop an AML-specific best-worst scaling (BWS) instrument involving 13 items in four domains (psychological, physical, decision-making, treatment delivery) to quantify patient worry. A survey of patients and caregivers was conducted using the instrument. Data were analyzed using conditional logistic regression.
AHRQ-funded; HS000032.
Citation: Richardson DR, Oakes AH, Crossnohere NL .
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Psychooncology 2021 Jul;30(7):1104-11. doi: 10.1002/pon.5652..
Keywords: Cancer, Patient Experience, Caregiving, Outcomes, Patient-Centered Outcomes Research
Amin AP, Rao SV, Seto AH
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
The study’s objective was to examine whether the association between transradial percutaneous coronary intervention (PCI; TRI) use versus transfemoral PCI (TFI) and in-hospital outcomes is influenced by baseline risk. TRI was found to reduce adverse outcomes when compared with TFI. The authors analyzed 28,005 PCIs performed in a 7-hospital system between July 2009 and April 2018. TRI use increased over time. However a risk-treatment paradox for TRI use was observed not only for bleeding risk, but for acute kidney injury (AKI) and death. The absolute risk difference between TRI and TFI increased with increasing baseline risk.
AHRQ-funded; HS022481.
Citation: Amin AP, Rao SV, Seto AH .
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
Circ Cardiovasc Interv 2021 Jul;14(7):e009328. doi: 10.1161/circinterventions.120.009328..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Barbash IJ, Davis BS, Yabes JG
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
This study evaluated the effect of Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) on treatment patterns and patient outcomes. Findings showed that, two years after its implementation, SEP-1 was associated with variable changes in process measures, with the greatest effect being an increase in lactate measurement within 3 hours of sepsis onset. There were small increases in antibiotic administration and fluid administration, a small increase in ICU admissions, and no changes in mortality or discharge to home.
Citation: Barbash IJ, Davis BS, Yabes JG .
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
Ann Intern Med 2021 Jul;174(7):927-35. doi: 10.7326/m20-5043..
Keywords: Sepsis, Medicare, Outcomes, Quality Measures, Quality of Care
Greenberg CC, Byrnes ME, Engler TA
Association of a statewide surgical coaching program with clinical outcomes and surgeon perceptions.
Investigators assessed risk-adjusted outcomes and participant perceptions following a statewide coaching program for bariatric surgeons. They found that this surgical coaching program was perceived as valuable and surgeons reported numerous practice changes. Additionally, operative times improved, but there was no significant improvement in risk-adjusted outcomes.
AHRQ-funded; HS023597.
Citation: Greenberg CC, Byrnes ME, Engler TA .
Association of a statewide surgical coaching program with clinical outcomes and surgeon perceptions.
Ann Surg 2021 Jun;273(6):1034-39. doi: 10.1097/sla.0000000000004800..
Keywords: Surgery, Provider: Physician, Provider Performance, Outcomes