National Healthcare Quality and Disparities Report
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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 25 of 66 Research Studies DisplayedChen R, Strait KM, Dharmarajan K
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
This study investigates how contemporary hospitals use this resource-intensive setting of intensive care units (ICUs) and whether higher use is associated with better outcomes. It found that rates of ICU admission for patients with AMI vary substantially across hospitals and were not associated with differences in mortality, but were associated with greater use of critical care therapies.
AHRQ-funded; HS020672.
Citation: Chen R, Strait KM, Dharmarajan K .
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
Am Heart J 2015 Dec;170(6):1161-9. doi: 10.1016/j.ahj.2015.09.003.
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Keywords: Hospitalization, Intensive Care Unit (ICU), Heart Disease and Health
Lee GE, Fisher BT, Xiao R
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
The researchers investigated the rate of influenza hospitalizations and attributable mortality in children with cancer. They concluded that the burden of influenza-related hospitalizations in children with acute lymphoblastic leukemia is high and associated with significantly increased resource utilization and attributable mortality.
AHRQ-funded; HS020939.
Citation: Lee GE, Fisher BT, Xiao R .
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
J Pediatric Infect Dis Soc 2015 Dec;4(4):290-6. doi: 10.1093/jpids/piu066..
Keywords: Children/Adolescents, Hospitalization, Influenza, Mortality, Children/Adolescents
Ericson JE, Popoola VO, Smith PB
Burden of invasive staphylococcus aureus infections in hospitalized infants.
This study compared demographics and mortality of inf ants with invasive methicillin-resistant S aureus (MRSA) and methicillin-susceptible S aureus (MSSA), to determine the annual proportion of S aureus infections that were MRSA. It found that infant mortality after invasive MRSA and MSSA infections was similar, but MSSA caused more infections and more deaths in infants than MRSA.
AHRQ-funded; HS022872.
Citation: Ericson JE, Popoola VO, Smith PB .
Burden of invasive staphylococcus aureus infections in hospitalized infants.
JAMA Pediatr 2015 Dec;169(12):1105-11. doi: 10.1001/jamapediatrics.2015.2380..
Keywords: Newborns/Infants, Methicillin-Resistant Staphylococcus aureus (MRSA), Mortality, Hospitalization, Risk
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
Stockmann C, Ampofo K, Pavia AT
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
This study compared outcomes between oral therapy and (outpatient parenteral antibiotic therapy (OPAT) for pediatric parapneumonic empyema (PPE) . The frequency of complications was similar with oral therapy and OPAT for children with PPE. Oral antibiotics may be considered safe and effective for children with PPE who will be discharged to complete therapy in the outpatient setting.
AHRQ-funded; HS023320.
Citation: Stockmann C, Ampofo K, Pavia AT .
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
Hosp Pediatr 2015 Dec;5(12):605-12. doi: 10.1542/hpeds.2015-0100.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Medication, Hospitalization, Children/Adolescents
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Gabayan GZ, Derose SF, Chiu VY
Emergency department crowding and outcomes after emergency department discharge.
The researchers assess whether a panel of emergency department (ED) crowding measures, including 2 reported by the Centers for Medicare & Medicaid Services (CMS), is associated with inpatient admission and death within 7 days of ED discharge. Their findings suggest that ED length of stay is a proxy for unmeasured differences in case mix and challenge the validity of the CMS metric as a safety measure for discharged patients.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Derose SF, Chiu VY .
Emergency department crowding and outcomes after emergency department discharge.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospital Discharge, Outcomes, Hospitalization
Ananth P, Melvin P, Feudtner C
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
The researchers assessed hospital resource use in children by type and number of life-threatening complex chronic conditions (LT-CCCs). They found that hospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/ immunologic or multiple conditions have the greatest hospital use.
AHRQ-funded; HS023092.
Citation: Ananth P, Melvin P, Feudtner C .
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
Pediatrics 2015 Nov;136(5):938-46. doi: 10.1542/peds.2015-0260..
Keywords: Chronic Conditions, Children/Adolescents, Hospitalization, Palliative Care
Olfson M, Wang S, Blanco C
National trends in hospital-treated self-harm events among middle-aged adults.
This study assessed national trends in hospital-treated self-harm events focusing on adults aged 45-64years. Between 2001 and 2011, there was a disproportionate national increase in hospital-treated self-harm events among middle-aged adults that mirrored national trends in suicide. The increase was largely accounted for by an overall increase in mental health hospitalizations of middle-aged adults.
AHRQ-funded; HS021112.
Citation: Olfson M, Wang S, Blanco C .
National trends in hospital-treated self-harm events among middle-aged adults.
Gen Hosp Psychiatry 2015 Nov-Dec;37(6):613-9. doi: 10.1016/j.genhosppsych.2015.08.004.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Behavioral Health, Hospitalization
Sentell T, Miyamura J, Ahn HJ
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
The authors studied congestive heart failure (CHF) hospitalizations among racial groups. They found that high preventable CHF hospitalization rates are seen in some Asian and Pacific Islander groups, especially Native Hawaiians and Filipinos, who have these hospitalizations at younger ages than other studied groups.
AHRQ-funded; HS019990.
Citation: Sentell T, Miyamura J, Ahn HJ .
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
J Immigr Minor Health 2015 Oct;17(5):1289-97. doi: 10.1007/s10903-014-0098-4.
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Keywords: Heart Disease and Health, Hospitalization, Prevention, Racial and Ethnic Minorities, Social Determinants of Health
Carls GS, Henke RM, Karaca Z
AHRQ Author: Karaca Z, Wong HS
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
The researchers assessed the association between unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995–2011. They found that for both adults and seniors, a 1 percent increase in the unemployment rate was associated with a statistically significant decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Carls GS, Henke RM, Karaca Z .
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
Health Serv Res 2015 Oct;50(5):1688-709. doi: 10.1111/1475-6773.12298..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Healthcare Utilization, Hospitalization
Valley TS, Sjoding MW, Ryan AM
Association of intensive care unit admission with mortality among older patients with pneumonia.
The purpose of this study was to estimate the relationship between ICU admission and outcomes for elderly patients with pneumonia. It concluded that among Medicare beneficiaries hospitalized with pneumonia, ICU admission of patients for whom the decision appeared to be discretionary was associated with improved survival and no significant difference in costs.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Association of intensive care unit admission with mortality among older patients with pneumonia.
JAMA 2015 Sep 22-29;314(12):1272-9. doi: 10.1001/jama.2015.11068..
Keywords: Patient Safety, Intensive Care Unit (ICU), Elderly, Mortality, Hospitalization
Teshome BF, Lee GC, Reveles KR
Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.
The study objective was to assess the effect of initial MRSA therapy on mortality in community–onset (CO) pneumonia patients that a new MRSA prediction score had classified into low, medium, and high-risk groups based on objective criteria available at baseline. The study demonstrated improved survival with initial MRSA therapy in the 2 percent of CO-pneumonia patients classified as high-risk.
AHRQ-funded; HS022418.
Citation: Teshome BF, Lee GC, Reveles KR .
Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.
BMC Infect Dis 2015 Sep 18;15:380. doi: 10.1186/s12879-015-1119-1..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Risk, Patient-Centered Outcomes Research, Hospitalization
Heo HH, Sentell TL, Li D
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
The researchers compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. They found that older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care.
AHRQ-funded; HS019990.
Citation: Heo HH, Sentell TL, Li D .
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
Prev Chronic Dis 2015 Sep 17;12:E152. doi: 10.5888/pcd12.150057.
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Keywords: Disparities, Racial and Ethnic Minorities, Hospitalization, Prevention, Chronic Conditions
Smith MW, Friedman B, Karaca Z
AHRQ Author: Friedman B, Karaca Z, Wong HS
Predicting inpatient hospital payments in the United States: a retrospective analysis.
The researchers evaluated whether payment-to-charge ratios (PCRs) can be predicted for hospitals in States that do not provide detailed financial data. They found that inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance.
AHRQ-authored.
Citation: Smith MW, Friedman B, Karaca Z .
Predicting inpatient hospital payments in the United States: a retrospective analysis.
BMC Health Serv Res 2015 Sep 10;15(1):372. doi: 10.1186/s12913-015-1040-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Healthcare Costs, Hospitalization
Page DB, Donnelly JP, Wang HE
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
The researchers sought to compare and contrast community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis hospitalizations in a national hospital sample. They found that hospital-acquired severe sepsis was associated with both higher mortality and resource utilization than community-acquired severe sepsis and healthcare-associated severe sepsis.
AHRQ-funded; HS013852.
Citation: Page DB, Donnelly JP, Wang HE .
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
Crit Care Med 2015 Sep;43(9):1945-51. doi: 10.1097/ccm.0000000000001164..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Hospitalization
Tilden EL, Lee VR, Allen AJ
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
The purpose of this study was to assess the outcomes and costs of hospital admission during the latent versus active phase of labor. It found that delaying admission until active labor would result in 672,000 fewer epidurals, 67,232 fewer cesarean deliveries, and 9.6 fewer maternal deaths in our theoretic cohort as compared to admission during latent labor.
AHRQ-funded; HS017582.
Citation: Tilden EL, Lee VR, Allen AJ .
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
Birth 2015 Sep;42(3):219-26. doi: 10.1111/birt.12179..
Keywords: Labor and Delivery, Comparative Effectiveness, Healthcare Costs, Patient-Centered Outcomes Research, Hospitalization
Pop-Vicas A, Rahman M, Gozalo PL
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
This study estimated the effect of influenza vaccination on hospitalization and mortality in nursing home (NH) residents. It found that the association between vaccine match and reduction in overall mortality and pneumonia and influenza hospitalizations was strongest for A/H3N2, the influenza strain typically responsible for the most-severe influenza cases.
AHRQ-funded; HS018462.
Citation: Pop-Vicas A, Rahman M, Gozalo PL .
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
J Am Geriatr Soc 2015 Sep;63(9):1798-804. doi: 10.1111/jgs.13617..
Keywords: Influenza, Nursing Homes, Vaccination, Hospitalization
Zhang H, Masoudi FA, Li J
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
The objective of this study was to perform a national quality assessment of early β-blocker use during hospitalization for AMI over the past decade in China. It found that the use of early β-blocker therapy for patients with AMI in China is suboptimal, with underuse in patients who could benefit and substantial use among those who might be harmed.
AHRQ-funded; HS023000.
Citation: Zhang H, Masoudi FA, Li J .
National assessment of early beta-blocker therapy in patients with acute myocardial infarction in China, 2001-2011: The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Retrospective AMI study.
Am Heart J 2015 Sep;170(3):506-15.e1. doi: 10.1016/j.ahj.2015.05.012..
Keywords: Heart Disease and Health, Hospitalization, Patient-Centered Outcomes Research, Quality of Care
Kuo YF, Chen NW, Baillargeon J
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
The researchers compared the rates of potentially preventable hospitalizations in older diabetic patients who received primary care from nurse practitioners (NPs) only versus those who received care from primary care physicians only. Using potentially preventable hospitalizations as a quality indicator, they found that primary care provided by NPs was at least comparable with that provided by generalist physicians.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Chen NW, Baillargeon J .
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
Med Care 2015 Sep;53(9):776-83. doi: 10.1097/mlr.0000000000000406..
Keywords: Hospitalization, Primary Care, Comparative Effectiveness, Diabetes
Guo MW, Ahn HJ, Juarez DT
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older. It found that Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups.
AHRQ-funded; HS019990.
Citation: Guo MW, Ahn HJ, Juarez DT .
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
Prev Chronic Dis 2015 Aug 6;12:E124. doi: 10.5888/pcd12.150092..
Keywords: Mortality, Hospitalization, Diabetes, Racial and Ethnic Minorities, Elderly
Berry JG, Zaslavsky AM, Toomey SL
Recognizing differences in hospital quality performance for pediatric inpatient care.
This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3,974 hospitals in 44 states in the 2009 Kids’ Inpatient Database. It found that most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modest differences in performance from average, but most condition-specific measures do not.
AHRQ-funded; HS020513.
Citation: Berry JG, Zaslavsky AM, Toomey SL .
Recognizing differences in hospital quality performance for pediatric inpatient care.
Pediatrics 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Quality of Care