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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 25 of 130 Research Studies DisplayedCatchpole K, Cohen T, Alfred M
Human factors integration in robotic surgery.
This study used the example of robotic-assisted surgery (RAS) to explore the methodological and practical challenges of technology integration in surgery, provide examples of evidence-based improvements, and discuss the importance of systems engineering and clinical human factors research and practice. The authors reviewed studies on workload, communication, workflow, workspace, and coordination in robotic surgery, and then discuss the potential for improvement that these studies suggest within the wider healthcare system. They concluded that there is a growing need to understand and develop approaches to safety and quality improvement through human-systems integration at the frontline of care.
AHRQ-funded; HS026491.
Citation: Catchpole K, Cohen T, Alfred M .
Human factors integration in robotic surgery.
Hum Factors 2024 Mar; 66(3):683-700. doi: 10.1177/00187208211068946..
Keywords: Surgery
Chen VW, Rosen T, Dong Y
Case sampling for evaluating hospital postoperative morbidity in US surgical quality improvement programs.
This study examined whether US surgical quality improvement (QI) programs using case sampling is robust enough for identifying hospitals with higher than expected complications. Eligible patients were 18 years and older who underwent a noncardiac operation at US Department of Veterans Affairs (VA) hospitals with a record in the VA Surgical Quality Improvement Program (systematic sample) and the VA Corporate Data Warehouse surgical domain (100% of surgical cases). Most patients in both samples were men (90.2% vs 91.2%) and White (74.7% vs 74.5%). Overall, 30-day complication rates were 7.6% and 5.3% for the sample and universal review cohorts, respectively. Using over 2145 hospital quarters of data, hospitals were identified as an outlier in 15.0% of quarters using the sample and 18.2% with universal review. Average hospital quarterly complication rates were 4.7% for outliers identified using the sample only, 7.2% for universal only, and 7.4% for concurrent identification in both sources. For nonsampled cases, average hospital quarterly complication rates were 7.0% at outliers and 4.4% at nonoutliers. Among outlier hospital quarters in the sample, 54.2% were concurrently identified with universal review, and for those identified with universal review, 44.6% were concurrently identified using the sample.
AHRQ-funded; HS028560.
Citation: Chen VW, Rosen T, Dong Y .
Case sampling for evaluating hospital postoperative morbidity in US surgical quality improvement programs.
JAMA Surg 2024 Mar; 159(3):315-22. doi: 10.1001/jamasurg.2023.6524..
Keywords: Surgery, Quality Improvement, Quality of Care, Hospitals
Iantorno SE, Scaife JH, Bryce JR
Emergency department utilization for pediatric gastrostomy tubes across the United States.
This study investigated the number and nature of emergency department (ED) visits to community hospitals for pediatric gastrostomy tube complication. The authors used the 2019 Nationwide Emergency Department Sample to perform a retrospective cross-sectional analysis of pediatric patients (<18 y) with a primary diagnosis of gastrostomy tube complication. Their primary outcome was a potentially preventable ED visit, defined as an encounter that did not result in any imaging, procedures, or an inpatient admission. They observed 32,036 ED visits at 535 hospitals and 15,165 (47.3%) were potentially preventable. Median age was 2 years, and 17,707 (55%) were male. Compared to White patients, patients with higher odds of potentially preventable visits were Black and Hispanic. Patients with residential zip codes in the first, second, and third median household income quartiles had higher odds of potentially preventable visits compared to the highest.
AHRQ-funded; HS025776.
Citation: Iantorno SE, Scaife JH, Bryce JR .
Emergency department utilization for pediatric gastrostomy tubes across the United States.
J Surg Res 2024 Mar; 295:820-26. doi: 10.1016/j.jss.2023.11.028.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Healthcare Utilization, Surgery, Adverse Events
Hider AM, Gomez-Rexrode AE, Agius J
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
This scoping review assessed the body of literature examining episode-based bundled payment models effect on health care spending, utilization, and quality of care for surgical conditions. Bundled payment models let hospitals receive financial incentives to reduce spending on care provided to patients during a predefined clinical episode. The review queried four databases from inception through September 27, 2021. A total of 879 unique articles were found, of which 28 met final inclusion criteria. Of these studies, 23 out of 28 evaluated the impact of voluntary bundled payments in orthopedic surgery and found that bundled payments are associated with reduced spending on total care episodes, attributed primarily to decreases in post-acute care spending. This reduced spending did not worsen clinical outcomes (e.g., readmissions, complications, and mortality). Evidence for non-orthopedic surgery bundled payments remains limited.
AHRQ-funded; HS028606.
Citation: Hider AM, Gomez-Rexrode AE, Agius J .
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
Am J Surg 2024 Mar; 229:83-91. doi: 10.1016/j.amjsurg.2023.12.009.
Keywords: Surgery, Payment, Healthcare Costs
Wu J, Yuan CT, Moyal-Smith R
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
This study examines the role of electronic health records (EHRs) in implementing enhanced recovery pathways (ERPs) for perioperative surgical care. Interviews with informaticians and clinicians from eight US hospitals revealed three thematic clusters: "EHR difficulties," "EHR enablers," and "EHR barriers." Researchers concluded that high performers and improvers successfully integrated ERPs into EHRs with dedicated multidisciplinary teams, while others faced challenges. Early involvement of informatics expertise benefited ERP implementation and sustainability.
AHRQ-funded; 2332015000201.
Citation: Wu J, Yuan CT, Moyal-Smith R .
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
J Am Med Inform Assoc 2024 Feb 16; 31(3):591-99. doi: 10.1093/jamia/ocad237.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Evidence-Based Practice, Hospitals
Anderson KE, Wu RJ, Darden M
Medicare Advantage is associated with lower utilization of total joint arthroplasty.
To discover whether Medicare Advantage enrollees have a lower utilization of elective surgical procedures such as inpatient hip and knee total joint arthroplasty (TJA), which have usually been covered by traditional Medicare without restrictions, researchers conducted a cross-sectional study comparing traditional Medicare claims and Medicare Advantage encounter records for enrollees aged 65-85. Their results showed a lower incidence of TJA in Medicare Advantage enrollees. The interval from initial diagnosis to contact with an orthopedic surgeon and to the surgical procedure were shorter among traditional enrollees.
AHRQ-funded; HS000029.
Citation: Anderson KE, Wu RJ, Darden M .
Medicare Advantage is associated with lower utilization of total joint arthroplasty.
J Bone Joint Surg Am 2024 Feb 7; 106(3):198-205. doi: 10.2106/jbjs.23.00507..
Keywords: Medicare, Orthopedics, Surgery
Mattioli DD, Thomas GW, Long S
Fluoroscopic image-based behavior analysis can objectively explain subjective expert assessment of wire navigation skill.
This study evaluated best methods to assess surgical wire navigation skill, which can be objectively evaluated by analysis of intraoperative fluoroscopic image sequences. Prior work suggests that such image-based behavior analysis of operating room (OR) performance can predict performer experience level and agree with expert opinion (the current standard) on the quality of a final implant construct. Objective image-based evaluations were compared to expert assessments for entire technical OR performances. The relationship of three key variables were studied: (1) objective image-based criteria, (2) expert opinions, and (3) performing surgeon experience level. The authors used a paired-comparison survey of seven experts, based upon eight OR fluoroscopic wire navigation image sequences, which showed that the experts' preferences are best explained by objective metrics that reflect psychomotor and decision-making behaviors which are counter-productive to successful implant placement, like image count and behavior tally. One such behavior, adjustments away from goal, uniquely correlated well with all three key variables: a fluoroscopic image-based analysis composite score, expert consensus, and performer experience. The results confirmed that experts view less efficient technical behavior as indicative of lesser technical proficiency.
AHRQ-funded; HS022077; HS025353.
Citation: Mattioli DD, Thomas GW, Long S .
Fluoroscopic image-based behavior analysis can objectively explain subjective expert assessment of wire navigation skill.
J Orthop Res 2024 Feb; 42(2):404-14. doi: 10.1002/jor.25685..
Keywords: Surgery, Orthopedics
Cassidy DE, Shao Z, Howard R
Variability in surgical approaches to hernias in patients with ascites.
This study investigated variability in surgical approaches to hernias in patients with ascites. The authors used data from the Michigan Surgical Quality Collaborative and its corresponding Core Optimization Hernia Registry (MSQC-COHR), which captures specific patient, hernia, and operative characteristics at a population level within the state. This retrospective cohort reviewed patients with ascites who had ventral or inguinal hernia repair surgery between January 2020 and May 3, 2022. The primary outcome observed was incidence and surgical approach for both ventral and inguinal hernia cohorts, and secondary outcomes included 30-day adverse clinical outcomes as listed here: (ED visits, readmission, reoperation, and complications) and surgical priority (urgent/emergent vs elective). In the cohort of 176 patients with ascites, only 1.4% of ventral hernia patients underwent hernia repair surgery, and only 0.2% of inguinal hernia patients. The post-operative 30-day adverse clinical outcomes in both hernia surgery cohorts were greatly increased compared to those without ascites (ventral: 32%; inguinal: 30%). Readmission was the most common complication, with a rate of 15.9% in the inguinal cohort, and 19.3% in the ventral hernia cohort. Open repair was the most common surgical approach (ventral: 86%, open: 77%). Ventral hernias were most commonly considered as urgent or emergency surgery (60%), while inguinal was mostly presented as elective surgery (72%).
AHRQ-funded; HS025778.
Citation: Cassidy DE, Shao Z, Howard R .
Variability in surgical approaches to hernias in patients with ascites.
Surg Endosc 2024 Feb; 38(2):735-41. doi: 10.1007/s00464-023-10598-6..
Keywords: Surgery
Kalata S, Schaefer SL, Nuliyahu U
Low-volume elective surgery and outcomes in Medicare beneficiaries treated at hospital networks.
This cross-sectional study’s objective was to quantify low-volume surgery and associated outcomes within hospital networks. This study used Medicare Provider Analysis and Review data to examine fee-for-service beneficiaries aged 66 to 99 years who underwent 1 of 10 elective surgical procedures (abdominal aortic aneurysm repair, carotid endarterectomy, mitral valve repair, hip or knee replacement, bariatric surgery, or resection for lung, esophageal, pancreatic, or rectal cancers) in a network hospital from 2016 to 2018. Hospital volume for each procedure (calculated with the use of National Inpatient Sample data) was compared with yearly hospital volume standards for that procedure recommended by The Leapfrog Group. The authors analyzed primary outcomes which were postoperative complications, 30-day readmission, and 30-day mortality, stratified by the volume status of the hospital and network type. Secondary outcome was the availability of a different high-volume hospital within the same network or outside the network and its proximity to the patient (based on hospital referral region and zip code). In all, data were analyzed for 950,079 Medicare fee-for-service beneficiaries (average age 74.4 years; 621,138 females and 427,931 males) who underwent 1,049,069 procedures at 2469 hospitals within 382 networks. Of these networks, almost 100% [380 (99.5%)] had at least 1 low-volume hospital performing the elective procedure of interest. In 79.8% of procedures that were performed at low-volume hospitals, there was a hospital that met volume standards within the same network and hospital referral region located a median (IQR) distance of 29 (12-60) miles from the patient's home. In adjusted analyses, postoperative outcomes were inferior at low-volume hospitals compared with hospitals meeting volume standards, with a 30-day mortality of 8.1% at low-volume hospitals vs 5.5% at hospitals that met volume standards.
AHRQ-funded; HS028606.
Citation: Kalata S, Schaefer SL, Nuliyahu U .
Low-volume elective surgery and outcomes in Medicare beneficiaries treated at hospital networks.
JAMA Surg 2024 Feb; 159(2):203-10. doi: 10.1001/jamasurg.2023.6542.
Keywords: Surgery, Medicare, Hospitals, Outcomes
Hendren S, Ameling J, Rocker C
Validation of measures for perioperative urinary catheter use, urinary retention, and urinary catheter-related trauma in surgical patients.
This article described a retrospective cohort study to analyze the effects of non-infectious urinary catheter-related complications, such as measurements of indwelling urinary catheter overuse, catheter-related trauma, and urinary retention. Participants were 200 patients who were undergoing general surgery operations; 65% had an indwelling urinary catheter placed at the time of surgery, 16% had urinary retention, and 6% had urinary trauma. The authors concluded that this study suggests a persistent high rate of catheter use, significant rates of urinary retention and trauma, and variation in the management of retention.
AHRQ-funded; HS026912.
Citation: Hendren S, Ameling J, Rocker C .
Validation of measures for perioperative urinary catheter use, urinary retention, and urinary catheter-related trauma in surgical patients.
Am J Surg 2024 Feb; 228:199-205. doi: 10.1016/j.amjsurg.2023.09.027.
Keywords: Surgery, Adverse Events, Patient Safety
Montgomery KB, Fazendin JM, Chen H
Contemporary trends in extent of surgery for differentiated thyroid cancer with extrathyroidal extension.
The study aimed to investigate trends in surgical approaches for differentiated thyroid cancer (DTC) with gross extrathyroidal extension (ETE). Using the National Cancer Database, patients with +ETE DTC from 2010 to 2020 were analyzed. Among 5,851 patients, 92% underwent total thyroidectomy (TT), but later years showed increased lobectomy rates. The results of the study suggest a potential shift towards preferring lobectomy in low-risk DTC cases, while raising concerns about undertreating high-risk patients.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Fazendin JM, Chen H .
Contemporary trends in extent of surgery for differentiated thyroid cancer with extrathyroidal extension.
The study aimed to investigate trends in surgical approaches for differentiated thyroid cancer (DTC) with gross extrathyroidal extension (ETE). Using the National Cancer Database, patients with +ETE DTC from 2010 to 2020 were analyzed. Among 5,851 patients, 92% underwent total thyroidectomy (TT), but later years showed increased lobectomy rates. The results of the study suggest a potential shift towards preferring lobectomy in low-risk DTC cases, while raising concerns about undertreating high-risk patients..
Keywords: Cancer, Surgery, Cancer
Danielson EC, Li W, Suleiman L
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
The objective of this study was to determine if county- or patient-level social risk factors are associated with patient-reported outcomes after total knee replacement when added to the comprehensive joint replacement risk-adjustment model. Patient and outcomes data from the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement cohort were merged with the CDC Social Vulnerability Index. The findings indicated that patient-reported race, education, and income were associated with patient-reported pain or functional scores; pain improvement was negatively associated with Black race and positively associated with higher annual incomes. The authors concluded that these findings suggested that patient-level social factors warrant further investigation to promote health equity in patient-reported outcomes after total knee replacement.
Citation: Danielson EC, Li W, Suleiman L .
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
Health Serv Res 2024 Feb; 59(1):e14215. doi: 10.1111/1475-6773.14215.
Keywords: Surgery, Orthopedics, Medicare, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Liu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Oke I, Elze T, Miller JW
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
This cohort study compared the 5-year reoperation rates for children with intermittent exotropia (IXT). Reoperation rates for children with IXT treated with horizontal muscle strabismus surgery using bilateral lateral rectus recession (BLR) vs unilateral lateral rectus recession with medial rectus resection (RR) were compared. The authors examined data obtained from the Intelligent Research in Sight (IRIS) Registry on 7482 children (age, <18 years) with IXT who underwent horizontal eye muscle strabismus surgery, excluding children undergoing initial surgeries involving 3 or more horizontal muscles, vertical muscles, or reoperations. Primary outcome was the adjusted cumulative incidence of repeat horizontal muscle surgery within 5 years after the initial surgery. BLR was performed more frequently than RR (85.3% vs 14.7%), especially in younger children. After data adjustment, the 5-year cumulative incidence of reoperation was 21.3%. The adjusted 5-year cumulative incidence of reoperation was higher for BLR than for RR. Unilateral lateral rectus recession with medial rectus resection was associated with a lower 5-year reoperation risk compared with BLR. Younger age at time of initial surgery was associated with a higher reoperation risk.
AHRQ-funded; HS000063.
Citation: Oke I, Elze T, Miller JW .
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
JAMA Ophthalmol 2024 Jan; 142(1):48-52. doi: 10.1001/jamaophthalmol.2023.5288..
Keywords: Surgery, Risk
Scally CP, Yin H, Birkmeyer JD
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
The researchers compared high and low mortality hospitals in order to identify differences in patient care impacting safety. They concluded that high and low mortality hospitals both have high compliance with common quality measures; however, high mortality hospitals performed worse in other areas of perioperative care, indicating possible targets for quality improvement efforts.
AHRQ-funded; HS020937.
Citation: Scally CP, Yin H, Birkmeyer JD .
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
J Surg Oncol 2015 Dec;112(8):866-71. doi: 10.1002/jso.24085.
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Keywords: Surgery, Mortality, Quality Improvement, Outcomes, Patient Safety
Murugiah K, Wang Y, Desai NR
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
The researchers studied hospital performance on transcatheter aortic valve replacement (TAVR) using data from all Medicare fee-for-service (FFS) beneficiaries 65 years of age and older who underwent TAVR from January 1, 2011, to December 31, 2013. They found that for an individual patient, the between-hospital variation translates to a great than 2-fold higher risk of dying within 30 days for a patient undergoing TAVR at a hospital 1 SD above the national average compared with undergoing TAVR at a hospital 1 SD below; the between-hospital variation was
AHRQ-funded; HS023000.
Citation: Murugiah K, Wang Y, Desai NR .
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
J Am Coll Cardiol 2015 Dec 15;66(23):2678-79. doi: 10.1016/j.jacc.2015.10.008.
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Keywords: Cardiovascular Conditions, Hospitals, Medicare, Patient-Centered Outcomes Research, Surgery
Kronman MP, Hersh AL, Gerber JS
Identifying antimicrobial stewardship targets for pediatric surgical patients.
The authors examined the collective pool of all systemic antibiotics prescribed to children hospitalized for surgical conditions and identified common surgical conditions with highly variable and potentially unnecessary antibiotic use. They concluded that the use of vancomycin for pediatric cardiothoracic and neurosurgical patients, and broad-spectrum antipseudomonal agents for gastrointestinal surgery patients, represent potentially high-yield targets for stewardship efforts to reduce unnecessary antimicrobial use.
AHRQ-funded; HS023320.
Citation: Kronman MP, Hersh AL, Gerber JS .
Identifying antimicrobial stewardship targets for pediatric surgical patients.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e100-8. doi: 10.1093/jpids/piv022.
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Keywords: Antibiotics, Antimicrobial Stewardship, Children/Adolescents, Children/Adolescents, Surgery
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Rajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Strope SA, Vetter J, Elliott S
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
To assess the impact of surgery for benign prostatic hyperplasia (BPH) on use of medication (5-alpha reductase inhibitors, alpha blockers, antispasmodics), the researchers assessed preoperative and postoperative medication utilization among surgically treated men. They found that most patients experience durable improvement after surgical intervention for BPH. However, their results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures.
AHRQ-funded; HS019455.
Citation: Strope SA, Vetter J, Elliott S .
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
Urology 2015 Dec;86(6):1115-22. doi: 10.1016/j.urology.2015.07.019..
Keywords: Surgery, Medication, Patient-Centered Outcomes Research, Men's Health
Grenda TR, Pradarelli JC, Thumma JR
Variation in hospital episode costs with bariatric surgery.
This study examined hospital variation in episode costs for a common high-risk procedure that is a prime candidate for bundled payment programs (ie, bariatric surgery). It found that mean total payments for bariatric procedures varied from $11,086 to $13,073 per episode of care, resulting in a mean difference of $1,987 (16.5 percent difference) per episode of care between the lowest and highest hospital quartiles.
AHRQ-funded; HS000053.
Citation: Grenda TR, Pradarelli JC, Thumma JR .
Variation in hospital episode costs with bariatric surgery.
JAMA Surg 2015 Dec;150(12):1109-15. doi: 10.1001/jamasurg.2015.2394.
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Keywords: Surgery, Obesity, Healthcare Costs
Goldberg J, Paugh TA, Dickinson TA
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
The researchers describe the relationship between acute normovolemic hemodilution (ANH) and red blood cell (RBC) transfusions after cardiac surgery using a multicenter registry. They found a significant association between ANH and reduced perioperative RBC transfusion in cardiac surgery. Transfusion reduction is most profound with larger volumes of ANH.
AHRQ-funded; HS022535; HS022909.
Citation: Goldberg J, Paugh TA, Dickinson TA .
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
Ann Thorac Surg 2015 Nov;100(5):1581-7; discussion 87. doi: 10.1016/j.athoracsur.2015.04.135.
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Keywords: Cardiovascular Conditions, Surgery, Registries
Britt RC, Scerbo MW, Montano M
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
The researchers hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores. They found that the increase in mental workload is indexed by both an increase in suturing times and a decrease in the ability to attend to the secondary task.
AHRQ-funded; HS020386.
Citation: Britt RC, Scerbo MW, Montano M .
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
Surgery 2015 Nov;158(5):1428-33. doi: 10.1016/j.surg.2015.03.032..
Keywords: Surgery, Patient Safety, Simulation, Training
Grenda TR, Revels SL, Yin H
Lung cancer resection at hospitals with high vs low mortality rates.
The objective of this study was to evaluate perioperative outcomes in patients who underwent lung cancer resection at high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) in order to better understand the factors related to differences in mortality rates after lung cancer resection. It concluded that failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection.
AHRQ-funded; HS000053; HS020937.
Citation: Grenda TR, Revels SL, Yin H .
Lung cancer resection at hospitals with high vs low mortality rates.
JAMA Surg 2015 Nov;150(11):1034-40. doi: 10.1001/jamasurg.2015.2199..
Keywords: Cancer: Lung Cancer, Surgery, Mortality, Outcomes, Patient Safety