National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (8)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Diagnostic Safety and Quality (1)
- Elderly (4)
- Emergency Department (1)
- Emergency Preparedness (1)
- Evidence-Based Practice (1)
- Falls (3)
- Healthcare-Associated Infections (HAIs) (8)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- (-) Hospitals (16)
- Infectious Diseases (1)
- (-) Injuries and Wounds (16)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (2)
- Orthopedics (1)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Safety (7)
- Payment (1)
- Prevention (2)
- Provider Performance (2)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (3)
- Risk (4)
- Shared Decision Making (1)
- Surgery (8)
- Tools & Toolkits (2)
- Trauma (3)
- Women (1)
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 16 of 16 Research Studies DisplayedNguyen JK, P P
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
This study’s objective was to compare level 1 and 2 trauma centers with similarly sized non-trauma centers on survival after major trauma among older adults. The authors used claims of 100% of 2012-2017 Medicare fee-for-service beneficiaries who received hospital care after major trauma. They assessed the roles of prehospital care, hospital quality, and volume. Thirty-day mortality was higher overall at level 1 versus non-trauma centers by 2.2 percentage points (pp). Thirty-day mortality was higher at level 1 versus non-trauma centers by 2.3 pp for falls and 2.3 pp for motor vehicle crashes. Outcomes were similar at level 1 and 2 trauma centers. The difference was not explained by hospital quality and volume. There were also no statistical differences in the ambulance-transported group, after adjusting for prehospital variables.
AHRQ-funded; HS025720.
Citation: Nguyen JK, P P .
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
Health Serv Res 2023 Aug; 58(4):817-27. doi: 10.1111/1475-6773.14148..
Keywords: Elderly, Trauma, Outcomes, Injuries and Wounds, Emergency Department, Hospitals
Bowman JA, Nuño M, Jurkovich GJ
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
Researchers characterized interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and evaluated whether greater hospital-level use of ICU admission is associated with improved outcomes. This study included trauma patients who were admitted to trauma centers participating in the National Trauma Data Bank. The researchers found that admission location of older patients with isolated rib fractures was variable across hospitals, but hospitalization at a center with greater ICU use was associated with improved outcomes. They recommended that hospitals with low ICU use admit more such patients to an ICU.
AHRQ-funded; HS022236.
Citation: Bowman JA, Nuño M, Jurkovich GJ .
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
JAMA Netw Open 2020 Nov 2;3(11):e2026500. doi: 10.1001/jamanetworkopen.2020.26500..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Hospitals, Patient-Centered Outcomes Research, Outcomes, Mortality
Dykes PC, Burns Z, Adelman J
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
The purpose of this study was to assess whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalization is associated with reduced falls and injurious falls. Findings showed that, in this nonrandomized controlled trial, implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient-care team partnership appeared to be beneficial for prevention of falls and fall-related injuries.
AHRQ-funded; HS023535.
Citation: Dykes PC, Burns Z, Adelman J .
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
JAMA Netw Open 2020 Nov 2;3(11):e2025889. doi: 10.1001/jamanetworkopen.2020.25889..
Keywords: Falls, Injuries and Wounds, Prevention, Tools & Toolkits, Patient and Family Engagement, Patient-Centered Healthcare, Clinical Decision Support (CDS), Hospitalization, Hospitals
Otto L, Wang A, Wheeler K
Comparison of manual and computer assigned injury severity scores.
The study objective was to compare the ISS manually assigned by hospital personnel and those generated by the ICDPIC software for value agreement and predictive power of length of stay (LOS) and mortality. The investigators found that the LOS and mortality predictive power were significantly higher for manually assigned ISS when compared with computer assigned ISS in both PTC and NTDB data sets. They indicated that hospitals should be cautious about transitioning to computer assigned ISS, specifically for patients who are critically injured.
AHRQ-funded; HS024263.
Citation: Otto L, Wang A, Wheeler K .
Comparison of manual and computer assigned injury severity scores.
Inj Prev 2020 Aug;26(4):330-33. doi: 10.1136/injuryprev-2019-043224..
Keywords: Health Information Technology (HIT), Injuries and Wounds, Trauma, Hospitals
Venema DM, Skinner AM, Nailon R
Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study.
Unassisted falls are more likely to result in injury than assisted falls. However, little is known about risk factors for falling unassisted. Furthermore, rural hospitals, which care for a high proportion of older adults, are underrepresented in research on hospital falls. This study identified risk factors for unassisted and injurious falls in rural hospitals.
AHRQ-funded; HS021429.
Citation: Venema DM, Skinner AM, Nailon R .
Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study.
BMC Geriatr 2019 Dec 11;19(1):348. doi: 10.1186/s12877-019-1368-8..
Keywords: Falls, Injuries and Wounds, Patient Safety, Elderly, Risk, Hospitals, Adverse Events
Rhee C, Wang Jentzsch, MS
Comparison of hospital surgical site infection rates and rankings using claims versus National Healthcare Safety Network surveillance data.
This article examines national policies that target healthcare-associated infections by use of medical claims and National Healthcare Safety Network surveillance data. The authors looked at rates and rankings for surgical site infection following colon surgery in 155 hospitals, and found low concordance between these two data sources; they conclude that this underscores the limitations of evaluating hospital quality by using claims data.
AHRQ-funded; HS025008; HS000063; HS018414.
Citation: Rhee C, Wang Jentzsch, MS .
Comparison of hospital surgical site infection rates and rankings using claims versus National Healthcare Safety Network surveillance data.
Infect Control Hosp Epidemiol 2019 Feb;40(2):208-10. doi: 10.1017/ice.2018.310..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Surgery, Injuries and Wounds
Yokoe DS, Avery TR, Platt R
Ranking hospitals based on colon surgery and abdominal hysterectomy surgical site infection outcomes: impact of limiting surveillance to the operative hospital.
This study examined how hospitals are ranked based on colon surgery and abdominal surgical site infection (SSI) outcomes. This ranking can impact how financial penalties are determined. Currently SSI surveillance focuses mainly on the operative hospital, but patients sometimes go to a different hospital after an SSI as opposed to readmission in the operative hospital. The authors used data from a California statewide hospital registry to assess for evidence of SSI for surgeries performed from March 2011 through November 2013. This analysis showed show that operational hospital surveillance alone would have missed 7.2% of colon surgery and 13.4% of abdominal hysterectomy SSIs. This leads to an inaccurate assignment or avoidance of financial penalties for approximately 1 in 11-16 hospitals.
AHRQ-funded; HS021424.
Citation: Yokoe DS, Avery TR, Platt R .
Ranking hospitals based on colon surgery and abdominal hysterectomy surgical site infection outcomes: impact of limiting surveillance to the operative hospital.
Clin Infect Dis 2018 Sep 14;67(7):1096-102. doi: 10.1093/cid/ciy223..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Injuries and Wounds, Adverse Events, Hospitals, Payment, Patient Safety, Provider Performance
Calderwood MS, Huang SS, Keller V
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
This study assesses hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validation. The authors concluded that claims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Huang SS, Keller V .
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1091-97. doi: 10.1017/ice.2017.134..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Women, Adverse Events, Diagnostic Safety and Quality, Hospitals
Dykes PC, Duckworth M, Cunningham S
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. The investigators examined strategies to integrate this evidence into clinical practice. They concluded that engaging hospital and clinical leadership is critical in translating evidence-based care into clinical practice. They address and detail barriers to adoption of the protocol to provide guidance for spread to other institutions.
AHRQ-funded; HS025128.
Citation: Dykes PC, Duckworth M, Cunningham S .
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Jt Comm J Qual Patient Saf 2017 Aug;43(8):403-13. doi: 10.1016/j.jcjq.2017.05.002..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Evidence-Based Practice, Falls, Hospitals, Injuries and Wounds, Inpatient Care, Patient Safety, Prevention, Risk, Tools & Toolkits
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Baker AW, Dicks KV, Durkin MJ
Epidemiology of surgical site infection in a community hospital network.
The researchers described the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens. They found that the prevalence of MRSA SSI decreased from 2008 to 2012. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence.
AHRQ-funded; HS023866.
Citation: Baker AW, Dicks KV, Durkin MJ .
Epidemiology of surgical site infection in a community hospital network.
Infect Control Hosp Epidemiol 2016 May;37(5):519-26. doi: 10.1017/ice.2016.13.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Adverse Events, Risk, Hospitals
Jenkins PC, Richardson CR, Norton EC
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
The authors developed a new measure of hospital capacity strain corresponding to trauma admissions and examined the relationship between trauma surges and inpatient mortality. Their Trauma Surge Index (TSI) method can be implemented by hospitals and trauma systems to examine periods of high-capacity strain retrospectively, identify specific resources that might have been needed, and better direct future investments in an evidence-based manner.
AHRQ-funded; HS020672.
Citation: Jenkins PC, Richardson CR, Norton EC .
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
J Am Coll Surg 2015 Sep;221(3):729-38.e1. doi: 10.1016/j.jamcollsurg.2015.05.016.
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Keywords: Emergency Preparedness, Hospitals, Injuries and Wounds, Mortality, Trauma
Kleweno CP, O'Toole RV, Ballreich J
Does fracture care make money for the hospital? An analysis of hospital revenues and costs for treatment of common fractures.
The authors sought to determine the relative profitability for a hospital of treatment of common fractures within a state-regulated reimbursement system. They found that the factors most influencing cost included length of stay, supplies, and operating room use, and that the most profitable diagnosis was pelvic fracture.
AHRQ-funded; HS000029.
Citation: Kleweno CP, O'Toole RV, Ballreich J .
Does fracture care make money for the hospital? An analysis of hospital revenues and costs for treatment of common fractures.
J Orthop Trauma 2015 Jul;29(7):e219-24. doi: 10.1097/bot.0000000000000263.
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Keywords: Injuries and Wounds, Healthcare Costs, Hospitals, Orthopedics
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care