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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.
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1 to 5 of 5 Research Studies DisplayedEverson J, Adler-Milstein JR, Hollingsworth JM
Dispersion in the hospital network of shared patients is associated with less efficient care.
The purpose of this study was to examine the level of distribution of patient-sharing networks across U.S. hospitals and its relationship with 3 measures of care delivered by hospitals that were likely to relate to coordination. The researchers utilized data from 2016 Medicare Fee-for-Service claims to measure the volume of patients that hospitals treated in common, and then calculated a measure of dispersion for each hospital. The relationship between network dispersion, Medicare spending per beneficiary, readmission rates, and emergency department (ED) throughput rates were then estimated. The study reported that hospitals with more dispersed networks had greater spending rates but not higher admission rates or slower ED processes. Among hospitals with less resources, more dispersion was associated with higher readmission rates and slower ED processes. The researchers concluded that dispersed interhospital networks create difficulties in coordinating patients who are treated at multiple hospitals, and that the structure of patient-sharing networks may be an overlooked factor that influences the delivery of care in health care organizations.
AHRQ-funded; HS026395, HS024525, HS024728, HS024454.
Citation: Everson J, Adler-Milstein JR, Hollingsworth JM .
Dispersion in the hospital network of shared patients is associated with less efficient care.
Health Care Manage Rev 2022 Apr-Jun;47(2):88-99. doi: 10.1097/hmr.0000000000000295..
Keywords: Medicare, Hospitals, Care Coordination, Healthcare Delivery
Post B, Norton EC, Hollenbeck B
Hospital-physician integration and Medicare's site-based outpatient payments.
AHRQ-funded; HS027044.
Citation: Post B, Norton EC, Hollenbeck B .
Hospital-physician integration and Medicare's site-based outpatient payments.
Health Serv Res 2021 Feb;56(1):7-15. doi: 10.1111/1475-6773.13613..
Keywords: Hospitals, Payment, Medicare, Ambulatory Care and Surgery, Healthcare Delivery
Borza T, Oerline MK, Skolarus TA
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Accountable Care Organizations (ACOs) and readmission rates following major surgery. A retrospective cohort study was conducted using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures: abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty between 2010 and 2014. Thirty-day risk-adjusted readmission rates was the primary outcome studied. Out of 2974 hospitals in the study, 389 were ACO affiliated. While rates fell for both cohorts, ACO hospitals had a higher decrease in hospitalizations over the same time period.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Oerline MK, Skolarus TA .
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Ann Surg 2019 May;269(5):873-78. doi: 10.1097/sla.0000000000002737..
Keywords: Hospitals, Surgery, Hospital Readmissions, Medicare, Healthcare Costs, Healthcare Delivery
Bazzoli GJ, Harless DW, Chukmaitov AS
A taxonomy of hospitals participating in Medicare accountable care organizations.
In this study, the investigators identified hospital ACO participant subgroups that share certain capabilities and competencies to provide deeper understanding of the structure and operation of these organizations. Their findings provide a baseline to track the evolution of accountable care organization (ACO) hospitals over time. The authors suggest that ACOs need to consider not only geographic and service mix when selecting hospital participants but also their vertical integration features and management competencies.
AHRQ-funded; HS023332.
Citation: Bazzoli GJ, Harless DW, Chukmaitov AS .
A taxonomy of hospitals participating in Medicare accountable care organizations.
Health Care Manage Rev 2019 Apr/Jun;44(2):93-103. doi: 10.1097/hmr.0000000000000159..
Keywords: Healthcare Delivery, Hospitals, Medicare
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare