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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedMin SH, Song J, Evans L
Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis.
The purpose of this study was to explore subgroups of older adults receiving home healthcare services with similar psychological, cognitive, and behavioral symptom profiles and an at-risk subgroup for future hospitalization and emergency department visits as an indicator of underdiagnosis or undertreatment. The three-class model applied in the study consisted of Class 1: "Moderate psychological symptoms without behavioral issues," Class 2: "Severe psychological symptoms with behavioral issues," and Class 3: "Mild psychological symptoms without behavioral issues." The study found that Class 1 patients had 1.14 higher odds and Class 2 patients had 1.26 higher odds of being hospitalized or visiting emergency departments compared to Class 3. The researchers discovered significant differences in individual characteristics such as age, gender, race/ethnicity, and insurance.
AHRQ-funded; HS027742.
Citation: Min SH, Song J, Evans L .
Home healthcare patients with distinct psychological, cognitive, and behavioral symptom profiles and at-risk subgroup for hospitalization and emergency department visits using latent class analysis.
Clin Nurs Res 2023 Sep; 32(7):1021-30. doi: 10.1177/10547738231183026..
Keywords: Home Healthcare, Emergency Department, Hospitalization, Elderly
McGarry BE, Mao Y, Nelson D
Hospital proximity and emergency department use among assisted living residents.
The purpose of this retrospective cohort study was to explore the association between the distance of assisted living (AL) communities to the nearest hospital and AL residents' rates of emergency department (ED) utilization. The researchers hypothesized that when access to an ED is a shorter distance, AL-to-ED transfers are more common, especially for non-emergency conditions. The study found that among 540,944 resident-years from 16,514 AL communities, the median distance to the closest hospital was 2.5 miles. After statistical adjustment, a doubling of distance to the closest hospital was related with 43.5 fewer ED treat-and-release visits per 1000 resident years and no significant difference in the rate of ED visits resulting in an inpatient admission. Among ED treat-and-release visits, a doubling of distance was related with a 3.0% decrease in visits classified as nonemergent, and a 1.6% decrease in visits classified as emergent, not primary care treatable.
AHRQ-funded; HS026893.
Citation: McGarry BE, Mao Y, Nelson D .
Hospital proximity and emergency department use among assisted living residents.
J Am Med Dir Assoc 2023 Sep; 24(9):1349-55.e.5. doi: 10.1016/j.jamda.2023.05.002..
Keywords: Emergency Department, Elderly, Long-Term Care, Medicare, Hospitals
Hekman DJ, Cochran AL, Maru AP
Effectiveness of an emergency department-based machine learning clinical decision support tool to prevent outpatient falls among older adults: protocol for a quasi-experimental study.
This article described a research protocol for evaluating the effectiveness of an automated screening and referral intervention tool for patients receiving falls risk intervention. The study will attempt to quantify the impact of a machine learning (ML) clinical decision support intervention on patient behavior and outcomes. The primary analysis will obtain referral completion rates from different emergency departments. The findings will inform ongoing discussion on the use of ML and artificial intelligence to augment medical decision-making.
AHRQ-funded; HS027735.
Citation: Hekman DJ, Cochran AL, Maru AP .
Effectiveness of an emergency department-based machine learning clinical decision support tool to prevent outpatient falls among older adults: protocol for a quasi-experimental study.
JMIR Res Protoc 2023 Aug 3; 12:e48128. doi: 10.2196/48128..
Keywords: Clinical Decision Support (CDS), Emergency Department, Health Information Technology (HIT), Elderly, Falls
Smulowitz PB, Weinreb G, McWilliams JM
Association of functional status, cognition, social support, and geriatric syndrome with admission from the emergency department.
The objective of this cohort study was to determine the extent to which patient-level factors such as such as functional status, cognitive status, social supports, and geriatric syndromes are associated with rates of hospital admission following an emergency department (ED) visit. Survey data collected from participants or their proxies enrolled in the Health and Retirement Study were linked to Medicare fee-for-service claims data. The results suggested that key patient-level characteristics were associated with the decision to admit older patients to the hospital from the ED. The authors concluded that these factors will be critical to consider when devising strategies to reduce low-value admissions from the ED among older adult patients.
AHRQ-funded; HS025408.
Citation: Smulowitz PB, Weinreb G, McWilliams JM .
Association of functional status, cognition, social support, and geriatric syndrome with admission from the emergency department.
JAMA Intern Med 2023 Aug; 183(8):784-92. doi: 10.1001/jamainternmed.2023.2149..
Keywords: Elderly, Emergency Department
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.
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
Hoonakker PLT, Carayon P, Brown RL
Satisfaction of older patients with emergency department care: psychometric properties and construct validity of the Consumer Emergency Care Satisfaction Scale.
This study’s purpose to was examine the construct validity of the Consumer Emergency Care Satisfaction Scale (CECSS), designed to measure patient satisfaction in the emergency department (ED). The authors administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects. Using several criteria, they improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring.
AHRQ-funded; HS026624.
Citation: Hoonakker PLT, Carayon P, Brown RL .
Satisfaction of older patients with emergency department care: psychometric properties and construct validity of the Consumer Emergency Care Satisfaction Scale.
J Nurs Care Qual 2023 Jul-Sep; 38(3):256-63. doi: 10.1097/ncq.0000000000000694..
Keywords: Elderly, Emergency Department, Patient Experience