National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Antibiotics (1)
- Asthma (1)
- Behavioral Health (3)
- Cardiovascular Conditions (2)
- Care Management (4)
- Children/Adolescents (4)
- Community-Acquired Infections (1)
- Comparative Effectiveness (3)
- Critical Care (2)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Evidence-Based Practice (6)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Insurance (1)
- Heart Disease and Health (1)
- Hospitalization (8)
- Hospital Readmissions (1)
- Hospitals (6)
- Human Immunodeficiency Virus (HIV) (1)
- Influenza (1)
- (-) Inpatient Care (19)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (1)
- Medicare (1)
- Medication (5)
- Mortality (2)
- Neurological Disorders (3)
- Newborns/Infants (2)
- (-) Outcomes (19)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (12)
- Patient and Family Engagement (1)
- Pneumonia (1)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (3)
- Respiratory Conditions (2)
- Stroke (1)
- Teams (3)
- Transitions of Care (2)
- Urinary Tract Infection (UTI) (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 19 of 19 Research Studies DisplayedO'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
Aklilu AM, Kumar S, Yamamoto Y
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
This retrospective study examined the association of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use with patients who have KDIGO-defined acute kidney injury (AKI) during acute heart failure (AHF) hospitalizations and their kidney function recovery at 14 days and 30 days using time-varying multivariable Cox-regression analyses. The study looked at 3305 adults hospitalized across 5 Yale New Haven Health Systems between January 2020 and May 2022 with AHF complicated by KDIGO-defined AKI. Of those individuals hospitalized with AHF and AKI, 356 received SGLT2i following AKI diagnosis either as initiation or continuation. The rate of renal recovery was not significantly different among those exposed and unexposed to SGLT2i following AKI (adjusted HR 0.94). SGLT2i exposure was associated with lower risk of 30-day mortality (adjusted HR 0.45). Rates of renal recovery were similar between the exposed and nonexposed cohorts regardless of the proximity of SGLT2i exposure to AKI diagnosis.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Yamamoto Y .
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
Kidney360 2023 Oct; 4(10):1371-81. doi: 10.34067/kid.0000000000000250..
Keywords: Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Inpatient Care, Medication, Outcomes
Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
Kohn R, Harhay MO, Bayes B
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
The objective of this cohort study was to assess the association of bedspacing with patient-centered outcomes among United States patients admitted to general medicine services. The study compared internal medicine, family medicine and geriatric service patients who were bedspaced versus cohorted for the entirety of their hospital stay within three large, urban hospitals. Findings showed that bedspacing was associated with adverse patient-centered outcomes. Recommendations for future work included a need to confirm these findings, to understand mechanisms contributing to adverse outcomes, and to identify factors that mitigate these adverse effects in order to provide high-value, patient-centered care to hospitalized patients.
AHRQ-funded; HS026372.
Citation: Kohn R, Harhay MO, Bayes B .
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
BMJ Qual Saf 2021 Feb;30(2):116-22. doi: 10.1136/bmjqs-2019-010675..
Keywords: Patient-Centered Outcomes Research, Outcomes, Inpatient Care, Hospitals, Healthcare Delivery, Care Management, Adverse Events
Nijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Hall KK, Lim A, Gale B
The use of rapid response teams to reduce failure to rescue events: a systematic review.
This systematic review looked at studies on the evidence on the impact of rapid response teams (RRTs) on failure to rescue events. Articles from 2008 to 2018 were found on the impact of RRTs on failure to rescue events, including hospital mortality and in-hospital cardiac arrest events. Ten articles were identified for inclusion. Patient outcomes included hospital mortality (8 studies), in-hospital cardiac arrests (9 studies) and ICU transfer rates (5 studies). Moderate evidence was found linking the implementation of RRTs with decreased mortality and non-ICU cardiac arrest rates. Results linking RRTs to ICU transfer rates were inconclusive. Benefits of RRTs may take some time after implementation to be realized.
AHRQ-funded; 233201500013I.
Citation: Hall KK, Lim A, Gale B .
The use of rapid response teams to reduce failure to rescue events: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S3-s7. doi: 10.1097/pts.0000000000000748..
Keywords: Teams, Inpatient Care, Hospitals, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Stevens JP, Hatfield LA, Nyweide DJ
Association of variation in consultant use among hospitalist physicians with outcomes among Medicare beneficiaries.
Evidence is lacking on the consequences of high rates of inpatient consultation. The purpose of this study was to examine outcomes and resource use of patients cared for by hospitalists who use more inpatient consultation than their colleagues. The investigators concluded that hospitalists who obtained consultations more than their colleagues at the same institution were associated with greater use of health care resources without apparent mortality benefit.
AHRQ-funded; HS024288.
Citation: Stevens JP, Hatfield LA, Nyweide DJ .
Association of variation in consultant use among hospitalist physicians with outcomes among Medicare beneficiaries.
JAMA Netw Open 2020 Feb 5;3(2):e1921750. doi: 10.1001/jamanetworkopen.2019.21750..
Keywords: Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Inpatient Care
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Keshvani N, Berger K, Gupta A
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
Researchers initiated a quality improvement (QI) initiative in hospitals to improve respiratory rate measurement accuracy. Time-keeping devices were added to vital sign carts and patient care assistants were retrained on a newly modified workflow that included concomitant respiratory rate (RR) measurement during automated blood pressure measurement. The median RR measurement rate increased postintervention. This intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome. This QI initiative was interdisciplinary, low-cost, and low-tech.
AHRQ-funded; HS022418.
Citation: Keshvani N, Berger K, Gupta A .
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
J Hosp Med 2019 Nov 1;14(10):673-77. doi: 10.12788/jhm.3232..
Keywords: Patient-Centered Outcomes Research, Quality Improvement, Inpatient Care, Diagnostic Safety and Quality, Hospitals, Quality of Care, Outcomes
Oh ES, Needham DM, Nikooie R
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Oh ES, Needham DM, Nikooie R .
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):474-84. doi: 10.7326/m19-1859..
Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health, Prevention
Nikooie R, Neufeld KJ, Oh ES
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Nikooie R, Neufeld KJ, Oh ES .
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):485-95. doi: 10.7326/m19-1860.
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Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health
Desai S, Aronson PL, Shabanova V
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
This study compared rates of recurring bacteremic urinary tract infections (UTIs) among hospitalized infants who received parenteral antibiotics 7 days or less compared with infants who received long-term treatment defined as greater than 7 days. Among 115 infants with bactermic UTI, half received short-course parenteral antibiotics and no difference in 30-day UTI recurrence was found.
AHRQ-funded; HS026006.
Citation: Desai S, Aronson PL, Shabanova V .
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
Pediatrics 2019 Sep;144(3). doi: 10.1542/peds.2018-3844..
Keywords: Newborns/Infants, Antibiotics, Urinary Tract Infection (UTI), Medication, Inpatient Care, Hospitalization, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Hussain FS, Sosa T, Ambroggio L
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
This case-control study aimed to determine the predictive validity of an emergency transfer (ET) for outcomes in a free-standing children's hospital. Controls were matched in terms of age, hospital unit, and time of year. Patients who experienced an ET had a significantly higher likelihood of in-hospital mortality (22% vs 9%), longer ICU length of stay (4.9 vs 2.2 days), and longer posttransfer length of stay (26.4 vs 14.7 days) compared with controls (P < .03 for each).
AHRQ-funded; HS023827.
Citation: Hussain FS, Sosa T, Ambroggio L .
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
J Hosp Med 2019 Aug;14(8):482-85. doi: 10.12788/jhm.3219..
Keywords: Transitions of Care, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Outcomes, Patient-Centered Outcomes Research, Inpatient Care, Hospitalization, Hospitals, Healthcare Delivery
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Semenkovich TR, Olsen MA, Puri V
Current state of empyema management.
The goal of this study was to examine current treatment practices and outcomes for inpatient treatment of empyema. A comprehensive, longitudinal data set from the New York State Inpatient Database, encompassing an entire state cohort of hospitalized patients, was used. The cohort included 4,095 patients who were undergoing intervention for primary empyema and were discharged 2009 to 2014 with chest tube, video-assisted thoracoscopic surgery (VATS) decortication and drainage, or open drainage and decortication. Patients were categorized into these three groups by definitive treatment during their initial hospitalization. The findings indicate that patients who were managed with chest tubes showed higher readmission and reintervention rates, suggesting that some of these patients may benefit from earlier definitive surgical intervention.
AHRQ-funded; HS019455.
Citation: Semenkovich TR, Olsen MA, Puri V .
Current state of empyema management.
Ann Thorac Surg 2018 Jun;105(6):1589-96. doi: 10.1016/j.athoracsur.2018.02.027..
Keywords: Care Management, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Outcomes, Respiratory Conditions
Hines AL, Raetzman SO, Barrett ML
AHRQ Author: Moy E, Andrews RM
Managed care and inpatient mortality in adults: effect of primary payer.
This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service (FFS) plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS.
AHRQ-authored.
Citation: Hines AL, Raetzman SO, Barrett ML .
Managed care and inpatient mortality in adults: effect of primary payer.
BMC Health Serv Res 2017 Feb 8;17(1):121. doi: 10.1186/s12913-017-2062-1.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Inpatient Care, Mortality, Outcomes, Hospitalization, Medicare
Reistetter TA, Kuo YF, Karmarkar AM
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
This study examined geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke. Its findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
AHRQ-funded; HS022134.
Citation: Reistetter TA, Kuo YF, Karmarkar AM .
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
Arch Phys Med Rehabil 2015 Jul;96(7):1248-54. doi: 10.1016/j.apmr.2015.02.020..
Keywords: Stroke, Cardiovascular Conditions, Inpatient Care, Outcomes
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes