National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (2)
- Adverse Events (3)
- Ambulatory Care and Surgery (3)
- Antimicrobial Stewardship (1)
- Blood Pressure (1)
- Cancer (4)
- Cardiovascular Conditions (5)
- Care Management (3)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Community-Acquired Infections (1)
- Comparative Effectiveness (2)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Dialysis (3)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Insurance (1)
- Heart Disease and Health (6)
- Hepatitis (1)
- Hospitalization (4)
- Hospital Readmissions (2)
- Human Immunodeficiency Virus (HIV) (3)
- Imaging (1)
- (-) Kidney Disease and Health (37)
- Medication (1)
- Mortality (7)
- Outcomes (5)
- Palliative Care (1)
- Patient-Centered Outcomes Research (4)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Payment (2)
- Policy (2)
- Practice Patterns (1)
- Prevention (1)
- Racial and Ethnic Minorities (2)
- Registries (1)
- Respiratory Conditions (1)
- Risk (5)
- Sepsis (3)
- Shared Decision Making (1)
- Surgery (1)
- Transplantation (3)
- Treatments (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 25 of 37 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Lee T, Thamer M, Zhang Z
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
This observational study design was used to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed. The study concluded that despite extended central venous catheter dependence, elderly patients initiating hemodialysis with a central venous catheter who underwent arteriovenous fistula placement within 6 months had fewer hospitalizations due to infections and a lower likelihood of death than those receiving an arteriovenous graft.
AHRQ-funded; HS022931; HS021229
Citation: Lee T, Thamer M, Zhang Z .
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
Clin J Am Soc Nephrol 2017 Nov 7;12(11):1823-30. doi: 10.2215/cjn.01410217..
Keywords: Elderly, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research
Cotter D, Barrus D, Ma M
Effects of ESRD bundling on efficiency of U.S. dialysis centers.
The study aim was to evaluate whether the 2011 ESRD Prospective Payment System (PPS) improved the efficiency of U.S. dialysis centers and to identify which providers demonstrated changes in their efficiency after the PPS implementation. It found that about 36 percent of facilities were functioning efficiently in 2010, dropping to only 21-22 percent efficiently operating facilities in 2011-12.
AHRQ-funded; HS024190.
Citation: Cotter D, Barrus D, Ma M .
Effects of ESRD bundling on efficiency of U.S. dialysis centers.
Nephrol News Issues 2017 Oct 18.
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Keywords: Kidney Disease and Health, Payment, Ambulatory Care and Surgery
Platinga LC, King L, Patzer RE
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
The researchers examined the timing of readmissions of hemodialysis patients in the United States and its association with mortality among 285,795 prevalent adult Medicare-primary hemodialysis patients from a national registry. They concluded that regardless of timing, patients with readmissions had a higher risk of death within one year, compared to those with no readmissions.
AHRQ-funded; HS025018.
Citation: Platinga LC, King L, Patzer RE .
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
Kidney Int 2017 Oct;92(4):934-41. doi: 10.1016/j.kint.2017.03.025.
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Keywords: Kidney Disease and Health, Hospital Readmissions, Mortality
Amin AP, Bach RG, Caruso ML
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
The purpose of this study was to examine the national variation in acute kidney injury (AKI) incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after percutaneous coronary intervention (PCI). This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for percutaneous coronary intervention (PCI) in the United States.
AHRQ-funded; HS022481.
Citation: Amin AP, Bach RG, Caruso ML .
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
JAMA Cardiol 2017 Sep;2(9):1007-12. doi: 10.1001/jamacardio.2017.2156..
Keywords: Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Patient Safety, Heart Disease and Health, Practice Patterns
Muzaale AD, Althoff KN, Sperati CJ
Risk of end-stage renal disease in HIV-positive potential live kidney donors.
New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, the investigators compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III.
AHRQ-funded; 90047713.
Citation: Muzaale AD, Althoff KN, Sperati CJ .
Risk of end-stage renal disease in HIV-positive potential live kidney donors.
Am J Transplant 2017 Jul;17(7):1823-32. doi: 10.1111/ajt.14235..
Keywords: Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Kidney Disease and Health
Bostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care
Traino HM, West SM, Nonterah CW
Communicating About Choices in Transplantation (COACH).
This article presents pilot results of the behavioral communication intervention program, Communicating about Choices in Transplantation (COACH), designed to improve transplant candidates' communication about transplantation. The authors indicate that results provided preliminary support for the program's impact. Moreover, participant evaluations of the COACH were overwhelmingly positive. They noted that a more definitive program evaluation with a larger, more diverse sample is currently underway.
AHRQ-funded; HS018113; HS021312.
Citation: Traino HM, West SM, Nonterah CW .
Communicating About Choices in Transplantation (COACH).
Prog Transplant 2017 Mar;27(1):31-38. doi: 10.1177/1526924816679844..
Keywords: Clinician-Patient Communication, Communication, Shared Decision Making, Education: Patient and Caregiver, Kidney Disease and Health, Transplantation
McMahon BJ, Bruden D, Townsend-Bulson L
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
The researchers examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic infection. They found those infected with HCV genotype 3 to be at high risk for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
AHRQ-funded; HS000046.
Citation: McMahon BJ, Bruden D, Townsend-Bulson L .
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
Clin Gastroenterol Hepatol 2017 Mar;15(3):431-37.e2. doi: 10.1016/j.cgh.2016.10.012.
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Keywords: Hepatitis, Cancer, Kidney Disease and Health, Risk, Mortality
Rees MA, Dunn TB, Kuhr CS
Kidney exchange to overcome financial barriers to kidney transplantation.
Organ shortage is the major limitation to kidney transplantation in the developed world. This proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers.
AHRQ-funded; HS020610.
Citation: Rees MA, Dunn TB, Kuhr CS .
Kidney exchange to overcome financial barriers to kidney transplantation.
Am J Transplant 2017 Mar;17(3):782-90. doi: 10.1111/ajt.14106.
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Keywords: Transplantation, Healthcare Costs, Policy, Kidney Disease and Health, Kidney Disease and Health
Snyder GM, McCoy C, D'Agata EM
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Using a rigorously collected data set of antimicrobial use among patients receiving chronic hemodialysis, antimicrobial use was calculated using 3 different methodologies: daily defined dose, days of therapy, and start-stop days. Estimates of antimicrobial use varied by as much as 10-fold, depending on the type of antimicrobial.
AHRQ-funded; HS021666.
Citation: Snyder GM, McCoy C, D'Agata EM .
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Infect Control Hosp Epidemiol 2017 Mar;38(3):360-63. doi: 10.1017/ice.2016.290.
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Keywords: Adverse Drug Events (ADE), Antimicrobial Stewardship, Dialysis, Kidney Disease and Health, Patient Safety
Banerjee T, Meyer TW, Shafi T
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
P-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. The researchers explored the relationship between free and total PCS and indoxyl sulfate (IS) with infection-related hospitalizations (IH) and septicemia in 2 cohorts. Their results suggest an association between higher concentrations of free PCS and infection-related and sepsis-related hospitalizations in hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Banerjee T, Meyer TW, Shafi T .
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
Medicine 2017 Feb;96(6):e5799. doi: 10.1097/md.0000000000005799.
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Keywords: Hospitalization, Kidney Disease and Health, Kidney Disease and Health, Digestive Disease and Health, Sepsis
Erickson KF, Winkelmayer WC, Chertow GM
Hemodialysis hospitalizations and readmissions: the effects of payment reform.
The researchers used a retrospective cohort interrupted time-series study design to examine whether the 2004 nephrologist reimbursement reform led to reduced hospitalizations and rehospitalizations. They found no significant change in all-cause hospitalization or rehospitalization and slight reductions in fluid overload hospitalization and rehospitalization following reimbursement reform.
AHRQ-funded; HS019178.
Citation: Erickson KF, Winkelmayer WC, Chertow GM .
Hemodialysis hospitalizations and readmissions: the effects of payment reform.
Am J Kidney Dis 2017 Feb;69(2):237-46. doi: 10.1053/j.ajkd.2016.08.033.
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Keywords: Hospital Readmissions, Hospitalization, Kidney Disease and Health, Payment, Policy
Wang V, Maciejewski ML, Coffman CJ
Impacts of geographic distance on peritoneal dialysis utilization: refining models of treatment selection.
This study examined the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. It found a positive, nonlinear relationship between absolute distance to hemodialysis (HD) services and peritoneal dialysis (PD) use, with the magnitude of the effect increasing at greater distances.
AHRQ-funded; HS019479.
Citation: Wang V, Maciejewski ML, Coffman CJ .
Impacts of geographic distance on peritoneal dialysis utilization: refining models of treatment selection.
Health Serv Res 2017 Feb;52(1):35-55. doi: 10.1111/1475-6773.12489.
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Keywords: Dialysis, Access to Care, Healthcare Utilization, Kidney Disease and Health, Healthcare Delivery
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
Shafi T, Powe NR, Meyer TW
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
This study determined the association of the proatherogenic metabolite trimethylamine N-oxide (TMAO) with cardiovascular outcomes in hemodialysis patients and assessed whether this association differs by race. It found that, compared with blacks in the same quintile, whites in the highest quintile for TMAO (>/=135 muM) had a 4-fold higher risk of cardiac or sudden cardiac death and a 2-fold higher risk of any-cause death.
AHRQ-funded; HS008365.
Citation: Shafi T, Powe NR, Meyer TW .
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
J Am Soc Nephrol 2017 Jan;28(1):321-31. doi: 10.1681/asn.2016030374.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Cardiovascular Conditions
Goldstein SL
Automated/integrated real-time clinical decision support in acute kidney injury.
The author argues that early, real-time identification and notification to healthcare providers of patients at risk for, or with, acute or chronic kidney disease can drive simple interventions to reduce harm. Similarly, he believes that screening patients at risk for acute kidney injury with these platforms to alert research personnel will lead to improve study subject recruitment.
AHRQ-funded; HS023763; HS021114.
Citation: Goldstein SL .
Automated/integrated real-time clinical decision support in acute kidney injury.
Curr Opin Crit Care 2015 Dec;21(6):485-9. doi: 10.1097/mcc.0000000000000250.
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Keywords: Clinical Decision Support (CDS), Kidney Disease and Health, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Diagnostic Safety and Quality
Warnock DG, Powell TC, Donnelly JP
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
The objective of this study was to categorize hospital-associated acute kidney injury (HA-AKI) based on the timing of minimum and peak inpatient serum creatinine (sCr) and describe the association with inpatient mortality. It concluded that risk of short-term inpatient mortality is associated with AKI, and this risk is attenuated with recovery of kidney function in the hospital.
AHRQ-funded; HS013852.
Citation: Warnock DG, Powell TC, Donnelly JP .
Categories of hospital-associated acute kidney injury: time course of changes in serum creatinine values.
Nephron 2015;131(4):227-36. doi: 10.1159/000441956.
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Keywords: Kidney Disease and Health, Adverse Events, Hospitalization, Mortality
Scialla JJ, Parekh RS, Eustace JA
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
In this study, the researchers determined the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. They concluded that aberrant phosphorus homeostasis, reflected by higher phosphorus and FGF23, may be a risk factor for mortality in patients initiating hemodialysis, particularly among African Americans.
AHRQ-funded; HS08365.
Citation: Scialla JJ, Parekh RS, Eustace JA .
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
Am J Nephrol 2015;42(1):25-34. doi: 10.1159/000438999.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Mortality, Kidney Disease and Health
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
This study evaluated outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with chronic kidney disease (CKD). It found that In patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps heart attack, with no long-term mortality difference.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery.
J Am Coll Cardiol 2015 Sep 15;66(11):1209-20. doi: 10.1016/j.jacc.2015.06.1334..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Surgery, Kidney Disease and Health
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Weiss JW, Peters D, Yang X
Systolic BP and mortality in older adults with CKD.
This study sought to determine whether a nonlinear relationship between BP and mortality - as described for the broader chronic kidney disease (CKD) population and for older adults in the general population - is present for older adults with CKD. It found that in a cohort of older adults, a relationship between higher SBP and mortality was present only for younger members of this cohort and not for those older than 70.
AHRQ-funded; HS019456.
Citation: Weiss JW, Peters D, Yang X .
Systolic BP and mortality in older adults with CKD.
Clin J Am Soc Nephrol 2015 Sep 4;10(9):1553-9. doi: 10.2215/cjn.11391114.
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Keywords: Blood Pressure, Mortality, Elderly, Kidney Disease and Health
Erickson KF, Mell M, Winkelmayer WC
Provider visits and early vascular access placement in maintenance hemodialysis.
This study examined whether patients seen more frequently by their nephrologist or advanced practitioner in the first 90 days of hemodialysis were more likely to undergo surgery to create an AV fistula or place an AV graft during that period. It concluded that patients seen more frequently by care providers in the first 90 days of hemodialysis undergo earlier AV fistula creation or graft placement.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell M, Winkelmayer WC .
Provider visits and early vascular access placement in maintenance hemodialysis.
J Am Soc Nephrol 2015 Aug;26(8):1990-7. doi: 10.1681/asn.2014050464..
Keywords: Care Management, Kidney Disease and Health, Healthcare Utilization, Outcomes
Wang V, Lee SY, Maciejewski ML
Inertia in health care organizations: a case study of peritoneal dialysis services.
The aim of this study was to examine whether strategic and selective factors were associated with the provision of peritoneal dialysis (PD) services in outpatient dialysis facilities in the United States between 1995 and 2003. It found little support for strategic influences and some evidence that selective factors were predictive of dialysis facilities’ PD provision.
AHRQ-funded; HS019479; HS000032.
Citation: Wang V, Lee SY, Maciejewski ML .
Inertia in health care organizations: a case study of peritoneal dialysis services.
Health Care Manage Rev 2015 Jul-Sep;40(3):203-13. doi: 10.1097/hmr.0000000000000024..
Keywords: Kidney Disease and Health, Ambulatory Care and Surgery
Schroeder EB, Powers JD, O'Connor PJ
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
The researchers used a database including over 1 million individuals with diabetes to examine the prevalence of chronic kidney disease (CKD) and trends from 2005 to 2011. They found that CKD prevalence was 20.0 percent using diagnostic codes, 17.7 percent using impaired estimated glomerular filtration rate alone, 11.9 percent using albuminuria, and 32.7 percent when one or more methods suggested CKD.
AHRQ-funded; HS019859
Citation: Schroeder EB, Powers JD, O'Connor PJ .
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
J Diabetes Complications. 2015 Jul;29(5):637-43. doi: 10.1016/j.jdiacomp.2015.04.007.
Keywords: Kidney Disease and Health, Diabetes, Chronic Conditions