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AHRQ Research Studies Date
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- Access to Care (1)
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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 8 of 8 Research Studies DisplayedGreenberg JK, Olsen MA, Dibble CF
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Investigators sought to evaluate the reliability of 90-day inpatient hospital costs, overall complications, and rates of serious complications for profiling hospital performance in lumbar fusion surgery for spondylolisthesis. Using HCUP data, they found that 90-day inpatient costs were highly reliable for assessing variation across hospitals, whereas overall and serious complications were only moderately reliable for profiling performance. They concluded that their results support the viability of emerging bundled payment programs that assume true differences in costs of care exist across hospitals.
AHRQ-funded; HS027075; HS019455.
Citation: Greenberg JK, Olsen MA, Dibble CF .
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Spine J 2021 Dec;21(12):2026-34. doi: 10.1016/j.spinee.2021.06.014..
Keywords: Healthcare Costs, Hospitals, Provider Performance, Surgery, Quality Measures, Quality of Care
Chhabra KR, Sheetz KH, Regenbogen SE
Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success.
Researchers sought to measure the extent of variation in episode spending around total hip replacement for fee-for-service Medicare patients within and across hospital systems identified in the American Hospital Association Annual Survey. They found that average episode payments varied nearly as much within hospital systems as they did between the lowest- and highest-cost quintiles of systems, with variation driven by post-acute care utilization.
AHRQ-funded; HS000053.
Citation: Chhabra KR, Sheetz KH, Regenbogen SE .
Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success.
Ann Surg 2021 Dec 1;274(6):e1078-e84. doi: 10.1097/sla.0000000000003741..
Keywords: Surgery, Health Systems, Medicare, Healthcare Costs, Hospitals
Desai SM, McWilliams JM
340B Drug Pricing Program and hospital provision of uncompensated care.
This study evaluated whether hospital entry into the 340B Drug Pricing Program is associated with changes in hospital provision of uncompensated care. The authors analyzed secondary data on 340B participation and uncompensated care provision among general acute care hospitals and critical access hospitals from 2003 to 2015. They constructed an annual, hospital-level data set on hospital 340B participation and on uncompensated care provision. They did not find evidence that hospitals increased provision of uncompensated care after entry into the 340B program differentially more than hospitals that never entered or had not yet entered the program.
AHRQ-funded; HS026980; HS024072.
Citation: Desai SM, McWilliams JM .
340B Drug Pricing Program and hospital provision of uncompensated care.
Am J Manag Care 2021 Oct;27(10):432-37. doi: 10.37765/ajmc.2021.88761..
Keywords: Hospitals, Healthcare Costs, Medication
Liao JM, Gupta A, Zhao Y
Association between hospital voluntary participation, mandatory participation, or nonparticipation in bundled payments and Medicare episodic spending for hip and knee replacements.
The purpose of this study was to examine and compare 2011-2017 spending for hip and joint replacements between hospitals with voluntary participation, mandatory participation and nonparticipation in the Medicare Bundled Payments for Care Improvement program.
Citation: Liao JM, Gupta A, Zhao Y .
Association between hospital voluntary participation, mandatory participation, or nonparticipation in bundled payments and Medicare episodic spending for hip and knee replacements.
JAMA 2021 Aug 3;326(5):438-40. doi: 10.1001/jama.2021.10046..
Keywords: Medicare, Hospitals, Payment, Surgery, Orthopedics, Healthcare Costs
Eisenberg MD, Meiselbach MK, Bai G
Large self-insured employers lack power to effectively negotiate hospital prices.
This study examined the ability of self-insured employers to negotiate hospital prices and investigated the relationship between hospital prices and employer market power in the United States. Findings showed that employer market power was low in most metropolitan statistical areas. Recommendations included encouraging self-insured employers to consider building purchase alliances with state and local government employee groups in order to enhance their market power and to lower negotiated prices for hospital services.
AHRQ-funded; HS000029.
Citation: Eisenberg MD, Meiselbach MK, Bai G .
Large self-insured employers lack power to effectively negotiate hospital prices.
Am J Manag Care 2021 Jul;27(7):290-96. doi: 10.37765/ajmc.2021.88702..
Keywords: Health Insurance, Medicare, Medicaid, Healthcare Costs, Hospitals
Williams D, Holmes GM, Song PH
For rural hospitals that merged, inpatient charges decreased and outpatient charges increased: a pre-/post-comparison of rural hospitals that merged and rural hospitals that did not merge between 2005 and 2015.
The purpose of this study was to determine whether inpatient and outpatient charges changed at rural hospitals after a merger. The investigators found that merging was strongly associated with a decrease in inpatient charges and somewhat associated with an increase in outpatient charges for rural hospitals. They indicated that future work could build upon their results to determine whether acquirers reduce or eliminate certain services at rural hospitals after a merger, and ultimately how changes in service delivery could impact patients in those rural communities.
AHRQ-funded; HS000032.
Citation: Williams D, Holmes GM, Song PH .
For rural hospitals that merged, inpatient charges decreased and outpatient charges increased: a pre-/post-comparison of rural hospitals that merged and rural hospitals that did not merge between 2005 and 2015.
J Rural Health 2021 Mar;37(2):308-17. doi: 10.1111/jrh.12461..
Keywords: Rural Health, Hospitals, Healthcare Costs
Martin BI, Brodke DS, Wilson FA
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
This study’s objective was to estimate excess demand for hospital beds due to COVID-19 and the net financial impact of eliminating elective admissions to meet demand. An economic simulation was conducted combining epidemiological reports, the US Census, American Hospital Association Annual Survey, and the National Inpatient Sample. The base case used relied on a hospital admission rate reported by the CDC of 137.6 per 100,000, with the highest rates in people aged 65 year and older and 50-64 years. Elective admissions accounted for 20% of total hospital admissions, with an average rate of 30% unoccupied beds across hospitals. Hospitals that restricted elective care due to a COVID surge was only financial favorable if capacity was filled by a high proportion of COVID-19 cases among hospitals with low rates of elective admissions. There is a substantial financial risk to hospitals that restrict elective care.
AHRQ-funded; HS024714.
Citation: Martin BI, Brodke DS, Wilson FA .
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
Med Care 2021 Mar;59(3):213-19. doi: 10.1097/mlr.0000000000001496..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Hospitals, Healthcare Costs, Access to Care, Public Health
Diaz A, Chhabra KR, Dimick JB
Variations in surgical spending within hospital systems for complex cancer surgery.
Researchers sought to measure variations in episode spending within and across hospital systems among Medicare beneficiaries undergoing complex cancer surgery. They found wide variations in surgical episode spending both within and across hospital systems. They recommended that system leaders seek better understanding of variations in practices among their hospitals to standardize care and reduce variations in outcomes, use, and costs.
AHRQ-funded; HS024763.
Citation: Diaz A, Chhabra KR, Dimick JB .
Variations in surgical spending within hospital systems for complex cancer surgery.
Cancer 2021 Feb 15;127(4):586-97. doi: 10.1002/cncr.33299..
Keywords: Surgery, Cancer, Healthcare Costs, Health Systems, Hospitals