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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 15 of 15 Research Studies DisplayedBradford W, Akselrod H, Bassler J
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
This multisite, retrospective cohort study of hospitalized patients with opioid use disorder with infectious complications of injection drug use looked at rates of HIV screening, pre-exposure prophylaxis, and treatment among these patients. The authors included 322 patients, with most (300) now known to have HIV. Of those, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 had a viral load collected during admission of whom all were viremic and 10 were successfully linked to care post-discharge. Both groups had high rates of readmission, Medicaid or uninsured status, and unstable housing.
AHRQ-funded; HS013852.
Citation: Bradford W, Akselrod H, Bassler J .
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
Addict Sci Clin Pract 2024 Mar 26; 19(1):22. doi: 10.1186/s13722-024-00451-z..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Prevention, Inpatient Care
Auerbach AD, Lee TM, Hubbard CC
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
The objective of this retrospective cohort study was to determine the prevalence, underlying causes, and harms of diagnostic errors in hospitalized adults who were transferred to an intensive care unit or who died. Data was taken from 29 academic medical centers in the U.S. in a random sample of adults hospitalized with general medical conditions. Errors were found to have contributed to temporary harm, permanent harm, or death in nearly 18% of patients; among patients who died, diagnostic error was judged to have contributed to death in 6.6% of cases. The researchers noted that problems with choosing and interpreting tests and the processes involved with clinician assessment were a high priority for improvement efforts.
AHRQ-funded; HS027369.
Citation: Auerbach AD, Lee TM, Hubbard CC .
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
JAMA Intern Med 2024 Feb; 184(2):164-73. doi: 10.1001/jamainternmed.2023.7347..
Keywords: Diagnostic Safety and Quality, Medical Errors, Hospitals, Inpatient Care, Quality of Care, Patient Safety, Adverse Events
Wolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Quinn M, Horowitz JK, Krein SL
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
The purpose of this study was to examine the roles, functions, and composition of vascular access teams (VATs) related to the use and management of PICC and midline catheters. The researchers administered an online survey of 62 hospitals participating in a quality improvement consortium and qualitative interviews with 74 hospital-based clinicians in 10 sites. The study found that more than 77% of hospitals had an on-site VAT. The average team size was seven nurses; their main function was device insertion. Findings from the interviews revealed variations in team characteristics and functions. Interviewees characterized the broad role that teams play in device insertion, care, and removal, and in educating/training hospital staff. The researchers found that teams' role in decision making, especially related to appropriate device selection, was limited an was met with physician resistance in some cases.
AHRQ-funded; HS025891.
Citation: Quinn M, Horowitz JK, Krein SL .
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
J Hosp Med 2024 Jan; 19(1):13-23. doi: 10.1002/jhm.13253..
Keywords: Patient Safety, Inpatient Care, Cardiovascular Conditions
Prey JE, Qian M, Restaino S
Reliability and validity of the patient activation measure in hospitalized patients.
The objectives of this article are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population. The authors found that patients with unplanned admissions were more likely to have low activation than patients with planned admissions. They also found that PAM-13 was modestly correlated with each of the PROMIS Global Health components: global, physical and mental health. They concluded that this study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission is an important predictor of patient activation.
AHRQ-funded; HS021816.
Citation: Prey JE, Qian M, Restaino S .
Reliability and validity of the patient activation measure in hospitalized patients.
Patient Educ Couns 2016 Dec;99(12):2026-33. doi: 10.1016/j.pec.2016.06.029.
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Keywords: Cancer, Cardiovascular Conditions, Hospitalization, Inpatient Care, Patient and Family Engagement
Singh H, Zwaan L
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
The authors argue that given the importance of diagnoses in the hospital, hospitalists are well-positioned to lead efforts to promote correct and timely diagnosis. However, to reduce harms from diagnostic errors, hospitalists must first understand how these errors occur and then develop practical strategies to avoid them.
AHRQ-funded; HS022087; HS023602.
Citation: Singh H, Zwaan L .
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
Ann Intern Med 2016 Oct 18;165(8):HO2-HO4. doi: 10.7326/m16-2042.
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Keywords: Medical Errors, Diagnostic Safety and Quality, Patient Safety, Health Information Technology (HIT), Inpatient Care
Her QL, Amato MG, Seger DL
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
The purpose of this study was to quantify the frequency of inappropriate nonformulary medication (NFM) alert overrides in the inpatient setting and provide insight on how the design of formulary alerts could be improved. The study found that approximately 1 in 5 NFM alert overrides are overridden inappropriately.
AHRQ-funded; HS021094.
Citation: Her QL, Amato MG, Seger DL .
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
J Am Med Inform Assoc 2016 Sep;23(5):924-33. doi: 10.1093/jamia/ocv181..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Inpatient Care, Medication, Patient Safety
Kronick R, Arnold S, Brady J
AHRQ Author: Arnold S, Brady J
Improving safety for hospitalized patients: much progress but many challenges remain.
Over the past few years hospitals have made substantial progress in reducing harms. The authors review the evidence demonstrating progress and what is known about the factors contributing to progress. The authors concluded that to parallel the effort that has been made to date on hospital safety, substantial effort is needed to determine how to measure and reduce diagnostic errors and ensure that this information is integrated into practice where it will translate into meaningful benefits for patients.
AHRQ-authored.
Citation: Kronick R, Arnold S, Brady J .
Improving safety for hospitalized patients: much progress but many challenges remain.
JAMA 2016 Aug 2;316(5):489-90. doi: 10.1001/jama.2016.7887.
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Keywords: Patient Safety, Hospitalization, Hospitals, Inpatient Care
Hsu DY, Gordon K, Silverberg JI
Serious infections in hospitalized patients with psoriasis in the United States.
The researchers sought to determine rates and predictors of serious infections in hospitalized psoriasis patients and quantify costs of care, length of stay, and mortality. Among patients with psoriasis, rates of serious infections increased over all time intervals analyzed and were significantly higher compared with those without psoriasis across all time intervals.
AHRQ-funded; HS023011.
Citation: Hsu DY, Gordon K, Silverberg JI .
Serious infections in hospitalized patients with psoriasis in the United States.
J Am Acad Dermatol 2016 Aug;75(2):287-96. doi: 10.1016/j.jaad.2016.04.005..
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Costs, Inpatient Care
Hochman MJ, Wolf S, Zafar SY
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
The researchers compared the unmet needs of palliative care patients by location of care to better characterize these populations. They found that outpatients are more burdened by pain at first palliative care encounter compared to inpatients, yet outpatients experience higher quality of life and better performance status.
AHRQ-funded; HS023681.
Citation: Hochman MJ, Wolf S, Zafar SY .
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
J Pain Symptom Manage 2016 Jun;51(6):1033-39.e3. doi: 10.1016/j.jpainsymman.2015.12.338.
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Keywords: Quality of Care, Inpatient Care, Ambulatory Care and Surgery, Palliative Care, Patient-Centered Outcomes Research
Masterson Creber R, Prey J, Ryan B
Engaging hospitalized patients in clinical care: study protocol for a pragmatic randomized controlled trial.
The purpose of this paper is to describe the protocol for a study to assess how patients' information needs during hospitalization can be addressed with health information technologies using a personalized inpatient portal. The study is designed to test whether the portal will improve patient engagement.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Prey J, Ryan B .
Engaging hospitalized patients in clinical care: study protocol for a pragmatic randomized controlled trial.
Contemp Clin Trials 2016 Mar;47:165-71. doi: 10.1016/j.cct.2016.01.005.
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Keywords: Health Information Technology (HIT), Hospitalization, Inpatient Care, Patient and Family Engagement, Web-Based
Sonik RA
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
This study investigated the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. It found that compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines.
AHRQ-funded; HS000062.
Citation: Sonik RA .
Massachusetts inpatient Medicaid cost response to increased supplemental nutrition assistance program benefits.
Am J Public Health 2016 Mar;106(3):443-8. doi: 10.2105/ajph.2015.302990.
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Keywords: Medicaid, Nutrition, Healthcare Costs, Inpatient Care
Miller AD, Mishra SR, Kendall L
Partners in care: Design considerations for caregivers and patients during a hospital stay.
The researchers described how caregivers and patients coordinate and collaborate to manage patients' care and wellbeing during a hospital stay. They defined and described five roles caregivers adopt: companion, assistant, representative, navigator, and planner, and show how patients and caregivers negotiate these roles and responsibilities throughout a hospital stay. Finally, they identified key design considerations for technology to support patients and caregivers during a hospital stay.
AHRQ-funded; HS022894.
Citation: Miller AD, Mishra SR, Kendall L .
Partners in care: Design considerations for caregivers and patients during a hospital stay.
Cscw 2016 Feb-Mar;2016:756-69. doi: 10.1145/2818048.2819983..
Keywords: Care Coordination, Caregiving, Hospitalization, Inpatient Care, Patient and Family Engagement
Grenda TR, Krell RW, Dimick JB
Reliability of hospital cost profiles in inpatient surgery.
This study sought to discover whether Medicare payments for surgery can reliably compare hospital costs. It found that episode payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume operations. These findings suggest that hospital cost profiles based on Medicare claims data may be used to benchmark efficiency, especially for more common procedures.
AHRQ-funded; HS000053.
Citation: Grenda TR, Krell RW, Dimick JB .
Reliability of hospital cost profiles in inpatient surgery.
Surgery 2016 Feb;159(2):375-80. doi: 10.1016/j.surg.2015.06.043..
Keywords: Inpatient Care, Surgery, Healthcare Costs, Medicare, Data
Wilcox L, Woollen J, Prey J
Interactive tools for inpatient medication tracking: a multi-phase study with cardiothoracic surgery patients.
This study explored the design and usefulness of patient-facing tools supporting inpatient medication management and tracking. Patients reported that the medication-tracking tools were useful. Patients' interview responses and audit logs revealed that they made frequent use of the hospital medications feature and found electronic reporting of questions and comments useful.
AHRQ-funded; HS021816; HS021393.
Citation: Wilcox L, Woollen J, Prey J .
Interactive tools for inpatient medication tracking: a multi-phase study with cardiothoracic surgery patients.
J Am Med Inform Assoc 2016 Jan;23(1):144-58. doi: 10.1093/jamia/ocv160..
Keywords: Electronic Health Records (EHRs), Inpatient Care, Medication, Patient Self-Management, Surgery