National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Cancer (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- (-) Healthcare Costs (9)
- Health Systems (2)
- (-) Hospitals (9)
- Inpatient Care (1)
- Medicare (2)
- Orthopedics (1)
- Payment (2)
- Provider Performance (2)
- Quality Improvement (1)
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- (-) Quality of Care (9)
- Surgery (3)
- 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 9 of 9 Research Studies DisplayedMcCleskey SG, Shek L, Grein J
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
This systematic review looked at economic evaluations of quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). A literature review was conducted for conference abstracts and studies from January 2000 to October 2020. Dual reviewers assessed study design, effectiveness, costs and study quality for eligibility. The reviewers performed a cost-consequence analysis from the hospital perspective, estimating the incidence rate ratio and increment net cost/savings per hospital over 3 years for each eligible study. Fifteen unique economic evaluations were eligible, and 12 studies were amenable to standardization. QI interventions were associated with a 43% decline in infections and wide ranges of net costs relative to usual care.
AHRQ-funded; HS022644.
Citation: McCleskey SG, Shek L, Grein J .
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
BMJ Qual Saf 2022 Apr;31(4):308-21. doi: 10.1136/bmjqs-2021-013839..
Keywords: Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Hospitals, Healthcare Costs
Greenberg JK, Olsen MA, Dibble CF
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Investigators sought to evaluate the reliability of 90-day inpatient hospital costs, overall complications, and rates of serious complications for profiling hospital performance in lumbar fusion surgery for spondylolisthesis. Using HCUP data, they found that 90-day inpatient costs were highly reliable for assessing variation across hospitals, whereas overall and serious complications were only moderately reliable for profiling performance. They concluded that their results support the viability of emerging bundled payment programs that assume true differences in costs of care exist across hospitals.
AHRQ-funded; HS027075; HS019455.
Citation: Greenberg JK, Olsen MA, Dibble CF .
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Spine J 2021 Dec;21(12):2026-34. doi: 10.1016/j.spinee.2021.06.014..
Keywords: Healthcare Costs, Hospitals, Provider Performance, Surgery, Quality Measures, Quality of Care
Machta RM, Reschovsky J, Jones DJ
AHRQ Author: Furukawa MF
Can vertically integrated health systems provide greater value: the case of hospitals under the comprehensive care for joint replacement model?
The authors sought to assess whether system providers perform better than non-system providers under an alternative payment model that incentivizes high-quality, cost-efficient care. Using CMS data linked to AHRQ’s Compendium of US Health Systems, along with secondary sources, they found that when operating under alternative payment model incentives, vertical integration may enable hospitals to lower costs with similar quality scores.
AHRQ-authored; AHRQ-funded; 290201600001C.
Citation: Machta RM, Reschovsky J, Jones DJ .
Can vertically integrated health systems provide greater value: the case of hospitals under the comprehensive care for joint replacement model?
Health Serv Res 2020 Aug;55(4):541-47. doi: 10.1111/1475-6773.13313..
Keywords: Health Systems, Hospitals, Orthopedics, Healthcare Costs, Payment, Quality of Care
Ho V, Metcalfe L, Vu L
Annual spending per patient and quality in hospital-owned versus physician-owned organizations: an observational study.
This study examined whether there are patient spending differences between practices owned by hospitals versus independent physician practices. The study used data from patients aged 19 to 64 enrolled in a Blue Cross Blue Shield Preferred Provider organization in the four largest metropolitan areas in Texas. Spending was found to be significantly higher for durable medical equipment, imaging, unclassified services, and outpatient care in hospital-owned practices. Estimates were that expenses were 5.8% higher in those practices.
AHRQ-funded; HS024727.
Citation: Ho V, Metcalfe L, Vu L .
Annual spending per patient and quality in hospital-owned versus physician-owned organizations: an observational study.
J Gen Intern Med 2020 Mar;35(3):649-55. doi: 10.1007/s11606-019-05312-z..
Keywords: Hospitals, Healthcare Costs, Quality of Care
Nathan H, Thumma JR, Ryan AM
Early impact of Medicare accountable care organizations on inpatient surgical spending.
This study evaluated whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. Medicare Shared Savings Programs (MSSP) have shown some modest success in reducing overall medical spending, but has not been studied on its impact in reducing surgical spending. Medicare claims from 2010 to 2014 were evaluated for patients aged 65 to 99 years undergoing 6 common elective surgical procedures: abdominal aortic aneurysm, colectomy, coronary artery bypass grafting, hip or knee replacement, or lung resection. A total of 341,675 patients at 427 ACO hospitals and over 1 million matched controls at non-ACO hospitals were used to compare surgical costs. There was not an overall reducing in total Medicare patients between the two hospital types.
AHRQ-funded; HS024763.
Citation: Nathan H, Thumma JR, Ryan AM .
Early impact of Medicare accountable care organizations on inpatient surgical spending.
Ann Surg 2019 Feb;269(2):191-96. doi: 10.1097/sla.0000000000002819..
Keywords: Healthcare Costs, Hospitals, Inpatient Care, Medicare, Surgery, Quality of Care
Shubeck SP, Thumma JR, Dimick JB
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
The authors evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. They found that the total episode expenditures for cancer resections were lower when care was delivered at low-complication, high-quality hospitals. Expenditure differences were particularly large for high-risk patients, suggesting that the selective referral of high-risk patients to high-quality centers may be an effective strategy for optimizing value in cancer surgery.
AHRQ-funded; HS024763.
Citation: Shubeck SP, Thumma JR, Dimick JB .
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
Cancer 2018 Feb 15;124(4):826-32. doi: 10.1002/cncr.31120.
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Keywords: Cancer, Healthcare Costs, Quality of Care, Hospitals, Surgery
Henke RM, Karaca Z, Moore B
AHRQ Author: Karaca Z, Wong HS
Impact of health system affiliation on hospital resource use intensity and quality of care.
This study assessed the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. It found that hospitals affiliated with health systems had a higher cost per discharge and better quality of care compared with independent hospitals. Centralized systems in particular had the highest cost per discharge and longest stays. Independent hospitals with managed care plans had a higher cost per discharge.
AHRQ-authored.
Citation: Henke RM, Karaca Z, Moore B .
Impact of health system affiliation on hospital resource use intensity and quality of care.
Health Serv Res 2018 Feb;53(1):63-86. doi: 10.1111/1475-6773.12631..
Keywords: Healthcare Costs, Quality of Care, Health Systems, Healthcare Cost and Utilization Project (HCUP), Hospitals
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care
David G, Lindrooth RC, Helmchen LA
Do hospitals cross-subsidize?
The authors used repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. They studied how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. They estimated that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose.
AHRQ-funded; HS010730.
Citation: David G, Lindrooth RC, Helmchen LA .
Do hospitals cross-subsidize?
J Health Econ 2014 Sep;37:198-218. doi: 10.1016/j.jhealeco.2014.06.007.
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Keywords: Healthcare Costs, Quality of Care, Hospitals