National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (9)
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- Children/Adolescents (3)
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- Depression (2)
- Digestive Disease and Health (1)
- Elderly (3)
- Electronic Health Records (EHRs) (4)
- Emergency Department (4)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (6)
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- Health Information Technology (HIT) (2)
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- Heart Disease and Health (4)
- Home Healthcare (1)
- Hospital Discharge (4)
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- (-) Hospital Readmissions (47)
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- Injuries and Wounds (2)
- Kidney Disease and Health (1)
- Medicaid (2)
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- Registries (1)
- Rehabilitation (1)
- Respiratory Conditions (1)
- (-) Risk (47)
- Sepsis (1)
- Social Determinants of Health (2)
- Stroke (2)
- Surgery (17)
- Tobacco Use (2)
- Transitions of Care (1)
- Transplantation (1)
- Urban Health (1)
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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
26 to 47 of 47 Research Studies DisplayedMoore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Macht R, Cassidy R, Cabral H
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
This study evaluated the association between readmissions and several organizational factors, including compliance with best practices to reduce unplanned hospital visits, major complication rates, and the emergency department-sourced readmission rate. It concluded that bariatric centers with higher rates of major complications and sites with emergency departments that are less likely to treat and discharge patients are more likely to have higher readmission rates.
AHRQ-funded; HS023621.
Citation: Macht R, Cassidy R, Cabral H .
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
Surg Obes Relat Dis 2017 Jun;13(6):1004-09. doi: 10.1016/j.soard.2016.12.029.
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Keywords: Adverse Events, Surgery, Hospital Readmissions, Risk
Jacobs BL, He C, Li BY
Variation in readmission expenditures after high-risk surgery.
The researchers sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. They found that the 30-day readmission rate was 16 percent for major chest and 22 percent for major abdominal surgery. Discharge to a skilled nursing facility was associated with higher readmission costs for both chest and abdominal surgeries.
AHRQ-funded; HS024403; HS023621.
Citation: Jacobs BL, He C, Li BY .
Variation in readmission expenditures after high-risk surgery.
J Surg Res 2017 Jun 1;213:60-68. doi: 10.1016/j.jss.2017.02.017.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Hospital Readmissions, Healthcare Costs, Risk
Horwitz LI, Bernheim SM, Ross JS
Hospital characteristics associated with risk-standardized readmission rates.
This national study using Medicare data examined the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR). Overall, larger, urban, academic facilities had modestly higher RSRRs than smaller, suburban, community hospitals, although there was a wide range of performance. The strong regional effect suggests that local practice patterns are an important influence.
AHRQ-funded; HS022882.
Citation: Horwitz LI, Bernheim SM, Ross JS .
Hospital characteristics associated with risk-standardized readmission rates.
Med Care 2017 May;55(5):528-34. doi: 10.1097/mlr.0000000000000713.
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Keywords: Hospitals, Hospital Readmissions, Medicaid, Risk, Quality of Care
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Graboyes EM, Kallogjeri D, Saeed MJ
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Researchers sought to determine patient and hospital-level risk factors associated with 30-day readmission for patients undergoing inpatient otolaryngologic surgery. Approximately one out of 12 patients undergoing otolaryngologic surgery had a 30-day readmission. Readmissions occur across a variety of types of procedures and hospitals. Most of the variability was driven by patient-specific factors, not structural hospital characteristics.
AHRQ-funded; HS019455.
Citation: Graboyes EM, Kallogjeri D, Saeed MJ .
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Laryngoscope 2017 Feb;127(2):337-45. doi: 10.1002/lary.25997.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Risk, Surgery
Nguyen OK, Makam AN, Clark C
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
This study assessed the association between vital sign instability at hospital discharge and post-discharge adverse outcomes. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 percent and positive likelihood ratio of 1.8 for 30-day death or readmission. Vital sign instability on discharge is thus associated with increased risk-adjusted rates of 30-day mortality and readmission.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
J Gen Intern Med 2017 Jan;32(1):42-48. doi: 10.1007/s11606-016-3826-8.
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Keywords: Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research, Risk
Nakagawa K, Ahn HJ, Taira DA
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
The authors sought to compare potentially preventable readmissions (PPR) among a multiethnic population in Hawaii. They concluded that the Chinese ethnicity may have a higher risk of 30-day PPR after stroke compared to whites. Other associated factors include mental illness, Medicaid, and Hawaii county.
AHRQ-funded; HS019990.
Citation: Nakagawa K, Ahn HJ, Taira DA .
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
Stroke 2016 Oct;47(10):2611-7. doi: 10.1161/strokeaha.116.013669.
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Keywords: Stroke, Racial and Ethnic Minorities, Hospital Readmissions, Hospitalization, Risk
Morris MS, Graham LA, Richman JS
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
The authors of this study aimed to understand the relative contribution of preoperative patient factors, operative characteristics, and postoperative hospital course on 30-day postoperative readmissions. They found that although postoperative readmissions are difficult to predict at the time of discharge, preoperative factors are the most important.
AHRQ-funded; HS013852.
Citation: Morris MS, Graham LA, Richman JS .
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
Ann Surg 2016 Oct;264(4):621-31. doi: 10.1097/sla.0000000000001855.
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Keywords: Hospital Readmissions, Surgery, Adverse Events, Risk, Risk
Weinreich M, Nguyen OK, Wang D
Predicting the risk of readmission in pneumonia. A systematic review of model performance.
The researchers synthesized the available literature on readmission risk prediction models for adults who are hospitalized because of pneumonia and described their performance. They found a limited number of validated pneumonia-specific readmission models, and their predictive ability was modest. To improve predictive accuracy, future models should include measures of pneumonia illness severity, hospital complications, and stability on discharge.
AHRQ-funded; HS022418.
Citation: Weinreich M, Nguyen OK, Wang D .
Predicting the risk of readmission in pneumonia. A systematic review of model performance.
Ann Am Thorac Soc 2016 Sep;13(9):1607-14. doi: 10.1513/AnnalsATS.201602-135SR.
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Keywords: Hospital Readmissions, Risk, Hospitalization
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Nguyen OK, Makam AN, Clark C
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
The purpose of this study was to develop an all-cause readmissions risk-prediction model incorporating electronic health record (EHR) data from the full hospital stay, and to compare "full-stay" model performance to a "first day" and 2 other validated models. It found that incorporating clinically granular EHR data from the full hospital stay modestly improves prediction of 30-day readmissions.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
J Hosp Med 2016 Jul;11(7):473-80. doi: 10.1002/jhm.2568.
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Risk
Jiang HJ, Boutwell AE, Maxwell J
AHRQ Author: Jiang HJ
Understanding patient, provider, and system factors related to Medicaid readmissions.
This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. It found that significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers.
AHRQ-authored; AHRQ-funded; 290201000034I; 290201000030I.
Citation: Jiang HJ, Boutwell AE, Maxwell J .
Understanding patient, provider, and system factors related to Medicaid readmissions.
Jt Comm J Qual Patient Saf 2016 Mar;42(3):115-21.
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Keywords: Medicaid, Hospital Readmissions, Access to Care, Social Determinants of Health, Risk
Iyer AS, Bhatt SP, Garner JJ
Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease.
The authors characterized the associations between depression and anxiety and COPD readmission risk. They found that depression is an independent risk factor for both short- and long-term readmissions for acute exacerbation of COPD and may represent a modifiable risk factor. They also found that in-hospital tobacco cessation counseling was associated with reduced 1-year readmission.
AHRQ-funded; HS013852.
Citation: Iyer AS, Bhatt SP, Garner JJ .
Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2016 Feb;13(2):197-203. doi: 10.1513/AnnalsATS.201507-439OC.
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Keywords: Respiratory Conditions, Depression, Hospital Readmissions, Risk, Tobacco Use
O'Connor M, Murtaugh CM, Shah S
Patient characteristics predicting readmission among individuals hospitalized for heart failure.
The authors conducted a literature review to identify heart failure patient characteristics, measured before discharge, that contribute to variation in hospital readmission rates. They found that no single patient characteristic stood out as a key contributor.
AHRQ-funded; HS020257.
Citation: O'Connor M, Murtaugh CM, Shah S .
Patient characteristics predicting readmission among individuals hospitalized for heart failure.
Med Care Res Rev 2016 Feb;73(1):3-40. doi: 10.1177/1077558715595156.
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Keywords: Heart Disease and Health, Patient-Centered Healthcare, Hospital Readmissions, Risk
Fisher SR, Graham JE, Krishnan S
Predictors of 30-day readmission following inpatient rehabilitation for patients at high risk for hospital readmission.
The purpose of this study was to identify variables in the full administrative medical record, particularly in regard to physical function, that could help clinicians further discriminate between patients who are and are not likely to be readmitted to an acute care hospital within 30 days of rehabilitation discharge. It found that functional outcomes and rehabilitation length of stay were the best predictors of 30-day rehospitalization.
AHRQ-funded; HS022134.
Citation: Fisher SR, Graham JE, Krishnan S .
Predictors of 30-day readmission following inpatient rehabilitation for patients at high risk for hospital readmission.
Phys Ther 2016 Jan;96(1):62-70. doi: 10.2522/ptj.20150034..
Keywords: Hospital Readmissions, Rehabilitation, Outcomes, Risk, Elderly
Rajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
Donnelly JP, Hohmann SF, Wang HE
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
The researchers sought to characterize 7- and 30-day readmission rates following hospital admission for severe sepsis as well as institutional variations in readmission. They concluded that severe sepsis readmission places a substantial burden on the healthcare system, with one in 15 and one in five severe sepsis discharges readmitted within 7 and 30 days, respectively.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Hohmann SF, Wang HE .
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
Crit Care Med 2015 Sep;43(9):1916-27. doi: 10.1097/ccm.0000000000001147..
Keywords: Hospital Readmissions, Hospitals, Risk, Sepsis
Amarasingham R, Velasco F, Xie B
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
The purpose of this study was to evaluate the degree to which electronic medical record-based risk models for 30-day readmission or mortality accurately identify high risk patients and to compare these models with published claims-based models. The researchers found that a new electronic multicondition model based on information derived from the electronic medical record predicted mortality and readmission at 30 days, and was superior to previously published claims-based models
AHRQ-funded; HS022418.
Citation: Amarasingham R, Velasco F, Xie B .
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
BMC Med Inform Decis Mak 2015 May 20;15:39. doi: 10.1186/s12911-015-0162-6.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Hospital Readmissions, Risk
Ayers DC, Fehring TK, Odum SM
Using joint registry data from FORCE-TJR to improve the accuracy of risk-adjustment prediction models for thirty-day readmission after total hip replacement and total knee replacement.
The authors argue that registry data offer the opportunity to combine clinical information currently available in registries (such as the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement [FORCE-TJR] registry based at the University of Massachusetts Medical School) with the administrative data currently used by CMS. Doing so will improve the risk adjustment for patients having total joint replacement by making the data more accurate and more fair for hospitals and surgeons.
AHRQ-funded; HS018910.
Citation: Ayers DC, Fehring TK, Odum SM .
Using joint registry data from FORCE-TJR to improve the accuracy of risk-adjustment prediction models for thirty-day readmission after total hip replacement and total knee replacement.
J Bone Joint Surg Am 2015 Apr 15;97(8):668-71. doi: 10.2106/jbjs.n.00889..
Keywords: Registries, Surgery, Hospital Readmissions, Risk
Santos CA, Brennan DC, Fraser VJ
Delayed-onset cytomegalovirus disease coded during hospital readmission after kidney transplantation.
The researchers sought to expand understanding of the scope, risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among kidney transplant reci
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Fraser VJ .
Delayed-onset cytomegalovirus disease coded during hospital readmission after kidney transplantation.
Transplantation. 2014 Jul 27;98(2):187-94. doi: 10.1097/TP.0000000000000030..
Keywords: Transplantation, Hospital Readmissions, Risk, Outcomes
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Depressive symptoms and hospital readmission in older adults.
The purpose of this study was to quantify the risk of 30-day unplanned hospital readmission in adults aged 65 and older with depressive symptoms. The investigators concluded that, although not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. They asserted that hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Depressive symptoms and hospital readmission in older adults.
J Am Geriatr Soc 2014 Mar;62(3):495-9. doi: 10.1111/jgs.12686..
Keywords: Depression, Elderly, Emergency Department, Hospital Readmissions, Risk