National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (1)
- (-) Elderly (4)
- Heart Disease and Health (1)
- Hospitalization (1)
- Medicare (1)
- Medication (1)
- Medication: Safety (1)
- Nursing Homes (1)
- Opioids (1)
- Orthopedics (1)
- Patient Safety (2)
- Risk (1)
- Shared Decision Making (1)
- (-) Surgery (4)
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 4 of 4 Research Studies DisplayedThompson MP, Stewart JW, Hou H
Determinants and outcomes associated with skilled nursing facility use after coronary artery bypass grafting: a statewide experience.
The purpose of this study was to assess determinants and outcomes related with Skilled nursing facility (SNF) use after isolated coronary artery bypass grafting. The study sample included 8,614 patients, with an average age of 73.3 years. A skilled nursing facility (SNF) was used by 22.3% of patients within 90 days of discharge and ranged from 3.2% to 58.3% across the 33 hospitals. Patients utilizing SNFs had a greater likelihood of being female, older, non-White, with greater comorbidities, worse cardiovascular function, a perioperative morbidity, and longer hospital lengths of stay. Outcomes were significantly worse for users of SNFs, including higher rates of 90-day readmissions and ED visits and lower use of home health and rehabilitation services. Compared with non-SNF users, users of SNFs had a greater risk-adjusted hazard of mortality and had 2.7-percentage point greater 5-year mortality rate in a propensity-matched cohort of patients.
AHRQ-funded; HS027830.
Citation: Thompson MP, Stewart JW, Hou H .
Determinants and outcomes associated with skilled nursing facility use after coronary artery bypass grafting: a statewide experience.
Circ Cardiovasc Qual Outcomes 2023 Oct; 16(10):e009639. doi: 10.1161/circoutcomes.122.009639..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Cardiovascular Conditions, Medicare, Surgery
Herzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Valentine KD, Vo H, Mancini B
Shared decision making for elective surgical procedures in older adults with and without cognitive insufficiencies.
The purpose of this study was to examine surgical decision-making processes of older adults with and without cognitive insufficiencies and to evaluate the psychometric properties of the shared decision making (SDM) Process scale. Participants were eligible patients aged 65 or older who were scheduled for a preoperative appointment before elective surgery; a baseline phone survey was administered a week before the visit and a follow-up survey 3 months later to assess decision regret. Survey responses indicated that patient-reported shared decision making, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies. The authors concluded that the SDM Process scale was an acceptable, reliable, and valid measure of shared decision making.
AHRQ-funded; HS025718.
Citation: Valentine KD, Vo H, Mancini B .
Shared decision making for elective surgical procedures in older adults with and without cognitive insufficiencies.
Med Decis Making 2023 Aug; 43(6):656-66. doi: 10.1177/0272989x231182436..
Keywords: Shared Decision Making, Elderly, Surgery
Silber JH, Rosenbaum PR, Reiter JG
The safety of performing surgery at ambulatory surgery centers versus hospital outpatient departments in older patients with or without multimorbidity.
The objective of this matched cohort study was to determine if there are differential outcomes in older patients undergoing surgical procedures at ambulatory surgery centers (ASCs) versus hospital outpatient departments (HOPDs). The results indicated that revisits and complication rates for ASC patients were lower than for closely matched HOPD patients. The observed initial baseline risk in HOPD patients was higher than the baseline risk for the same procedures performed at the ASC, which suggested that surgeons are selecting their riskier patients to be treated at the HOPD rather than the ASC.
AHRQ-funded; HS026897.
Citation: Silber JH, Rosenbaum PR, Reiter JG .
The safety of performing surgery at ambulatory surgery centers versus hospital outpatient departments in older patients with or without multimorbidity.
Med Care 2023 May; 61(5):328-37. doi: 10.1097/mlr.0000000000001836..
Keywords: Elderly, Surgery, Patient Safety, Ambulatory Care and Surgery