National Healthcare Quality and Disparities Report
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Topics
- Access to Care (3)
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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
51 to 75 of 116 Research Studies DisplayedHealy MA, Krell RW, Abdelsattar ZM
Pancreatic resection results in a statewide surgical collaborative.
This study sought to investigate changes over time in adverse outcomes after pancreatectomy across hospitals with different caseloads in a statewide surgical collaborative. It concluded that participation in regional quality collaboratives by lower-volume hospitals can attenuate the volume–outcome relationship for pancreatic surgery.
AHRQ-funded; HS20937; HS000053.
Citation: Healy MA, Krell RW, Abdelsattar ZM .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2468-74. doi: 10.1245/s10434-015-4529-9..
Keywords: Surgery, Patient Safety, Adverse Events, Hospitals, Quality Improvement, Quality of Care
Shah UH, Mandl LA, Mertelsmann-Voss C
Systemic lupus erythematosus is not a risk factor for poor outcomes after total hip and total knee arthroplasty.
The researchers sought to determine if systemic lupus erythematosus (SLE) remains an independent risk factor for poor arthroplasty outcomes or if other factors, such as avascular necrosis , continue to play a role. They found that SLE was not an independent risk factor for poor short-term pain or function after either hip or knee arthroplasty.
AHRQ-funded; HS016075.
Citation: Shah UH, Mandl LA, Mertelsmann-Voss C .
Systemic lupus erythematosus is not a risk factor for poor outcomes after total hip and total knee arthroplasty.
Lupus 2015 Aug;24(9):900-8. doi: 10.1177/0961203314566635.
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Keywords: Surgery, Risk, Outcomes, Adverse Events
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords: Sleep Problems, Surgery, Patient Safety, Risk, Heart Disease and Health, Respiratory Conditions, Chronic Conditions
Greenberg JK, Ladner TR, Olsen MA
Validation of an International Classification of Diseases, Ninth Revision Code algorithm for identifying Chiari Malformation type 1 surgery in adults.
The purpose of this study was to validate 2 ICD-9-CM code algorithms identifying patients undergoing CM-1 decompression surgery. It concluded that the ICD-9-CM code Algorithm 2 has excellent positive predictive value and good sensitivity to identify adult CM-1 decompression surgery.
AHRQ-funded; HS019455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Validation of an International Classification of Diseases, Ninth Revision Code algorithm for identifying Chiari Malformation type 1 surgery in adults.
Neurosurgery 2015 Aug;77(2):269-73. doi: 10.1227/neu.0000000000000778..
Keywords: Data, Diagnostic Safety and Quality, Surgery
Fink HA, Hemmy LS, MacDonald R
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
This study summarized evidence about cognitive outcomes in adults aged 65 years or older at least 3 months after coronary or carotid revascularization, cardiac valve procedures, or ablation for atrial fibrillation. It concluded that intermediate- and long-term cognitive impairment in older adults attributable to the studied cardiovascular procedures may be uncommon.
AHRQ-funded; 2902007100641.
Citation: Fink HA, Hemmy LS, MacDonald R .
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
Ann Intern Med 2015 Jul 21;163(2):107-17. doi: 10.7326/m14-2793..
Keywords: Cardiovascular Conditions, Elderly, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Moghavem N, Morrison D, Ratliff JK
Cranial neurosurgical 30-day readmissions by clinical indication.
The objects of this study were to determine population-level, 30-day, all-cause readmission rates for cranial neurosurgery and identify factors associated with readmission. It fund that the frequency of 30-day readmission rates for patients undergoing cranial neurosurgery varied by diagnosis between 14% and 24%. Important patient characteristics and comorbidities that were associated with an increased readmission risk were identified.
AHRQ-funded; HS018558.
Citation: Moghavem N, Morrison D, Ratliff JK .
Cranial neurosurgical 30-day readmissions by clinical indication.
J Neurosurg 2015 Jul;123(1):189-97. doi: 10.3171/2014.12.jns14447..
Keywords: Hospital Readmissions, Surgery, Patient Safety, Outcomes
Bangalore S, Guo Y, Samadashvili Z
Everolimus eluting stents versus coronary artery bypass graft surgery for patients with diabetes mellitus and multivessel disease.
The researchers used data from the New York State registries to assess the comparative effectiveness of coronary artery bypass graft (CABG) when compared with percutaneous intervention (PCI) using everolimus eluting stents (EES) on short- and long-term cardiovascular outcomes. They found that PCI using EES, the latest generation stents, was associated with lower early risk of death and stroke when compared with CABG surgery.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Everolimus eluting stents versus coronary artery bypass graft surgery for patients with diabetes mellitus and multivessel disease.
Circ Cardiovasc Interv 2015 Jul;8(7):e002626. doi: 10.1161/circinterventions.115.002626..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Registries, Surgery
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Dahabreh IJ, Steele DW, Shah N
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
The purpose of this review was to synthesize the evidence on the comparative effectiveness and safety of oral mechanical bowel preparation versus no preparation or enema. It found weak evidence suggesting that oral mechanical bowel preparation has similar effectiveness compared with no preparation with respect to all-cause mortality, anastomotic leakage, wound infection, and peritonitis for patients undergoing elective surgery for colorectal cancer.
AHRQ-funded; 290201200012I.
Citation: Dahabreh IJ, Steele DW, Shah N .
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
Dis Colon Rectum 2015 Jul;58(7):698-707. doi: 10.1097/dcr.0000000000000375..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Adverse Events
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
LoVerde ZJ, Mandl LA, Johnson BK
Rheumatoid arthritis does not increase risk of short-term adverse events after total knee arthroplasty: a retrospective case-control study.
More adverse events (AE) are reported after total knee arthroplasty (TKA) for patients with rheumatoid arthritis (RA) than for patients with osteoarthritis (OA). This study evaluates 6-month postoperative AE in a high-volume center in a contemporary RA cohort. It found that in a high-volume center, with high RA-specific experience, RA does not increase postoperative AE.
AHRQ-funded; HS016075.
Citation: LoVerde ZJ, Mandl LA, Johnson BK .
Rheumatoid arthritis does not increase risk of short-term adverse events after total knee arthroplasty: a retrospective case-control study.
J Rheumatol 2015 Jul;42(7):1123-30. doi: 10.3899/jrheum.141251..
Keywords: Adverse Events, Arthritis, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Tamirisa NP, Sheffield KM, Parmar AD
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
The researchers aimed to determine the variation in use attributable to the surgeon and facility and determine the patient, surgeon, and facility characteristics associated with the use of minimally invasive breast biopsy (MIBB). They found that lower surgeon and facility volume, longer surgeon years in practice, and smaller facility bed size were associated with lower rates of MIBB use.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Sheffield KM, Parmar AD .
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
Ann Surg 2015 Jul;262(1):171-8. doi: 10.1097/sla.0000000000000883..
Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Surgery
Krell RW, Reames BN, Hendren S
Surgical referral for colorectal liver metastases: a population-based survey.
The researchers sought to understand medical oncologists’ perspectives on referral for colorectal liver metastases (CLM). They found wide variation in surgical referral patterns for CLM. Many felt that bilobar disease and tumor size were contraindications to liver-directed therapy despite a lack of supporting data.
AHRQ-funded; HS020937.
Citation: Krell RW, Reames BN, Hendren S .
Surgical referral for colorectal liver metastases: a population-based survey.
Ann Surg Oncol 2015 Jul;22(7):2179-94. doi: 10.1245/s10434-014-4318-x..
Keywords: Cancer, Surgery, Guidelines, Practice Patterns
Gonzalez AA, Abdelsattar ZM, Dimick JB
Time-to-readmission and mortality after high-risk surgery.
This study used 5 years of data on Medicare beneficiaries undergoing high-risk surgical procedures to investigate whether postdischarge mortality varies by time to readmission. It found that surgical readmissions within 10 days of discharge are disproportionately common and associated with increased mortality independent of index complications.
AHRQ-funded; HS017765; HS000053.
Citation: Gonzalez AA, Abdelsattar ZM, Dimick JB .
Time-to-readmission and mortality after high-risk surgery.
Ann Surg 2015 Jul;262(1):53-9. doi: 10.1097/sla.0000000000000912..
Keywords: Patient Safety, Mortality, Hospital Readmissions, Adverse Events, Surgery
Lee DJ, Najari BB, Davison WL
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
This study assessed the national temporal trends in the surgical management of ED utilizing penile prosthesis (PP). It found that the surgical management of ED with PP changed significantly between 2001 and 2010. Also, the overall utilization of PP decreased, but its use in patients with significant medical comorbidities increased.
AHRQ-funded; HS000066.
Citation: Lee DJ, Najari BB, Davison WL .
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
J Sex Med 2015 Jul;12(7):1638-45. doi: 10.1111/jsm.12921..
Keywords: Healthcare Utilization, Men's Health, Patient-Centered Healthcare, Sexual Health, Surgery
Abdelsattar ZM, Hendren S, Wong SL
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
The researchers assessed the hospital-level variation in transfusion practices for packed red blood cells and the patient-level effects on outcomes after noncardiac general or vascular surgery, using population-based prospectively collected data. They found that postoperative transfusions after noncardiac surgery are associated with increased adverse postoperative outcomes, with the exception of postoperative myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
Ann Surg 2015 Jul;262(1):1-6. doi: 10.1097/sla.0000000000001264..
Keywords: Patient Safety, Surgery, Outcomes, Adverse Events
Poonawalla IB, Lairson DR, Chan W
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
This study investigated the cost-effectiveness of neoadjuvant chemotherapy (NAC) compared with that of standard primary debulking surgery. It concluded that NAC use before surgery has a favorable cost-effectiveness profile in the high-risk group alone at classic willingness-to-pay thresholds. Its use as a general first-line treatment in all patients is not supported.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Lairson DR, Chan W .
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
Value Health 2015 Jun;18(4):387-95. doi: 10.1016/j.jval.2015.01.005..
Keywords: Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Frasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Shih T, Ryan AM, Gonzalez AA
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
The authors aimed to project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. They found that minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery.
AHRQ-funded; HS018546.
Citation: Shih T, Ryan AM, Gonzalez AA .
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
Ann Surg 2015 Jun;261(6):1027-31. doi: 10.1097/sla.0000000000000778.
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Keywords: Hospitals, Medicare, Racial and Ethnic Minorities, Hospital Readmissions, Surgery
Saeed MJ, Dubberke ER, Fraser VJ
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous National Healthcare Safety Network surgery categories (amputation; bile duct, liver or pancreas; breast; colon; and hernia) in community hospitals in California, Florida, and New York. The 90-day SSI rates varied significantly within each of the 5 subgroups.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Dubberke ER, Fraser VJ .
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
Am J Infect Control 2015 Jun;43(6):617-23. doi: 10.1016/j.ajic.2015.02.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Patient Safety, Adverse Events
Vemana G, Vetter J, Chen L
Sources of variation in follow-up expenditure after radical cystectomy.
Follow-up care after radical cystectomy is poorly defined, with extensive variation in practice patterns. The researchers sought to determine sources of these variations in care as well as examine the economic effect of standardization of care on guideline-recommended care. The most variation in expenditure on follow-up care was at the patient level, largely based on node positivity, chemotherapy status, and final cancer stage.
AHRQ-funded; HS019455.
Citation: Vemana G, Vetter J, Chen L .
Sources of variation in follow-up expenditure after radical cystectomy.
Urol Oncol 2015 Jun;33(6):267.e31-7. doi: 10.1016/j.urolonc.2015.03.009..
Keywords: Cancer, Surgery, Healthcare Costs, Elderly
Singer SJ, Jiang W, Huang LC
Surgical team member assessment of the safety of surgery practice in 38 South Carolina hospitals.
This study assessed surgical team member perceptions of multiple dimensions of safe surgical practice in 38 South Carolina hospitals participating in a statewide initiative to implement surgical safety checklists. It found that overall, 78 percent of responses were positive about surgical safety at respondent’s hospitals, but in each survey dimension, from 16 percent to 40 percent of responses were neutral/negative.
AHRQ-funded; HS019631.
Citation: Singer SJ, Jiang W, Huang LC .
Surgical team member assessment of the safety of surgery practice in 38 South Carolina hospitals.
Med Care Res Rev 2015 Jun;72(3):298-323. doi: 10.1177/1077558715577479..
Keywords: Patient Safety, Surgery, Hospitals
Suskind AM, Zhang Y, Dunn RL
Understanding the diffusion of ambulatory surgery centers.
The objective of this study was to understand potential facilitators and/or barriers to the introduction of freestanding ambulatory surgical centers (ASCs) in the United States. It found that ASCs were more likely to open in hospital service areas that were urban, had higher per capita income, and less competition for outpatient surgery.
AHRQ-funded; HS020927; HS018726.
Citation: Suskind AM, Zhang Y, Dunn RL .
Understanding the diffusion of ambulatory surgery centers.
Surg Innov 2015 Jun;22(3):257-65. doi: 10.1177/1553350614546004..
Keywords: Ambulatory Care and Surgery, Access to Care, Surgery
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery