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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (2)
- Elderly (4)
- Evidence-Based Practice (3)
- Healthcare Utilization (1)
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- (-) Rehabilitation (9)
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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 9 of 9 Research Studies DisplayedReistetter TA, Dean JM, Haas AM
Development and evaluation of rehabilitation service areas for the United States.
The purpose of this study was to develop and characterize post-acute care Rehabilitation Service Areas (RSAs) in the US that reflect rehabilitation use by Medicare beneficiaries. Data was accessed from Medicare claims 2013-2015 and included patient records across all diagnostic groups. RSAs were described by provider type, population, and traveling patterns among beneficiaries. The authors conclude that RSAs as a tool for measurement can provide policy makers, researchers, and administrators with small-area boundaries to assess access, resources, and understanding of financing to improve practice and policy for post-acute care.
AHRQ-funded; HS024711.
Citation: Reistetter TA, Dean JM, Haas AM .
Development and evaluation of rehabilitation service areas for the United States.
BMC Health Serv Res 2023 Mar 1;23(1):204. doi: 10.1186/s12913-023-09184-2.
Keywords: Rehabilitation, Access to Care
Duncan MS, Robbins NN, Wernke SA
Geographic variation in access to cardiac rehabilitation.
Considerable regional disparities exist in the commencement of cardiac rehabilitation (CR), with only 10% to 40% of eligible patients at the state level participating. The potential factors contributing to these discrepancies, such as accessibility to CR facilities, remain insufficiently explored. The purpose of this study was to assess the impact of CR center availability on CR initiation among Medicare beneficiaries. The researchers utilized Medicare records to pinpoint CR-eligible Medicare beneficiaries and compute CR initiation rates at the hospital referral region (HRR) level. Linear regression was applied to evaluate the percentage variance in CR initiation explained by CR accessibility across HRRs. Geospatial hotspot analysis was performed to detect CR deserts, or counties where the patient-to-CR center ratio is notably high. The study found that between 2014 and 2017, 1,133,657 Medicare beneficiaries were eligible for CR, with 263,310 (23%) initiating CR. The West North Central Census Division exhibited the highest adjusted CR initiation rate (35.4%) and the greatest concentration of CR programs (6.58 per 1,000 CR-eligible Medicare beneficiaries). CR program density accounted for 21.2% of the regional variation in CR initiation at the HRR level. A total of 40 predominantly urban counties, encompassing 14% of the U.S. population aged ≥65 years, were identified as CR deserts due to limited CR access.
AHRQ-funded; HS022990
Citation: Duncan MS, Robbins NN, Wernke SA .
Geographic variation in access to cardiac rehabilitation.
J Am Coll Cardiol 2023 Mar 21;81(11):1049-60. doi: 10.1016/j.jacc.2023.01.016.
Keywords: Rehabilitation, Access to Care, Cardiovascular Conditions
Konnyu KJ, Thoma LM, Cao W
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
This systematic review sought to examine evidence on the benefits and harms of prehabilitation interventions for patients scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. Evidence from 13 total knee arthroplasty studies suggested that prehabilitation may result in increased strength and reduced length of hospital stays and may not lead to increased harms; it may be comparable in terms of pain, range of motion, and activities of daily living. No evidence or insufficient evidence was found for all other outcomes after total knee arthroplasty. No evidence or insufficient evidence was found for all total hip arthroplasty outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):1-10. doi: 10.1097/phm.0000000000002006..
Keywords: Rehabilitation, Orthopedics, Evidence-Based Practice, Surgery
Konnyu KJ, Pinto D, Cao W
Rehabilitation for total hip arthroplasty: a systematic review.
This systematic review sought to determine the comparative benefits and harms of rehabilitation interventions for patients who had undergone elective, unilateral total hip arthroplasty (THA) for the treatment of primary osteoarthritis. Evidence from 15 studies suggested that individual rehabilitation programs may not differ in terms of risk of harm, outcomes of pain, strength, activities of daily living, or quality of life. No differences in outcomes were found between different rehabilitation programs after THA. The authors concluded that further evidence is needed to inform decisions on which rehabilitation program attributes are most effective for various outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Pinto D, Cao W .
Rehabilitation for total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):11-18. doi: 10.1097/phm.0000000000002007..
Keywords: Rehabilitation, Orthopedics, Surgery, Evidence-Based Practice
Konnyu KJ, Thoma LM, Cao W
Rehabilitation for total knee arthroplasty: a systematic review.
This systematic review sought to determine comparative benefits and harms of rehabilitation interventions for patients had undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. Evidence from 53 studies suggested that diverse rehabilitation programs may lead to comparable improvements in pain, range of motion, and activities of daily living. No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period nor among various postacute rehabilitation programs. All findings were of low strength of evidence.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Rehabilitation for total knee arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):19-33. doi: 10.1097/phm.0000000000002008..
Keywords: Rehabilitation, Surgery, Orthopedics, Evidence-Based Practice
Nishi SP, Zhang W, Kuo YF
Pulmonary rehabilitation utilization in older adults with chronic obstructive pulmonary disease, 2003 to 2012.
The authors assessed the trends in pulmonary rehabilitation (PR) utilization and factors associated with its use in older adults with chronic obstructive pulmonary disease (COPD). They concluded that utilization of PR during the study period increased only 1.1% in these Medicare beneficiaries with COPD and remained low.
AHRQ-funded; HS020642; HS022134.
Citation: Nishi SP, Zhang W, Kuo YF .
Pulmonary rehabilitation utilization in older adults with chronic obstructive pulmonary disease, 2003 to 2012.
J Cardiopulm Rehabil Prev 2016 Sep-Oct;36(5):375-82. doi: 10.1097/hcr.0000000000000194.
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Keywords: Respiratory Conditions, Elderly, Patient-Centered Outcomes Research, Rehabilitation
Kelly JP, Hammill BG, Doll JA
The potential impact of expanding cardiac rehabilitation in heart failure.
The authors sought to characterize the patient population newly eligible for cardiac rehabilitation (CR) based on the 2014 CMS expanded coverage criteria. Their findings suggested that expansion of coverage for the newly eligible group is an important systems process to undertake to rapidly increase the participating eligible patients and that extension of CR coverage to the ineligible group should be considered.
AHRQ-funded; HS021092.
Citation: Kelly JP, Hammill BG, Doll JA .
The potential impact of expanding cardiac rehabilitation in heart failure.
J Am Coll Cardiol 2016 Aug 30;68(9):977-8. doi: 10.1016/j.jacc.2016.05.081.
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Keywords: Cardiovascular Conditions, Elderly, Healthcare Utilization, Heart Disease and Health, Rehabilitation
McDonough CM, Ni P, Coster WJ
Development of an IRT-based short form to assess applied cognitive function in outpatient rehabilitation.
The authors developed a 15-item outpatient rehabilitation self-report short form for the Activity Measure for Post-Acute Care Applied Cognition item bank. They concluded that their Applied Cognition outpatient short form demonstrated acceptable psychometric properties and provides a bridge to item response theory-based measurement when point-of-care computing is not available.
AHRQ-funded; HS021368.
Citation: McDonough CM, Ni P, Coster WJ .
Development of an IRT-based short form to assess applied cognitive function in outpatient rehabilitation.
Am J Phys Med Rehabil 2016 Jan;95(1):62-71. doi: 10.1097/phm.0000000000000340.
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Keywords: Elderly, Neurological Disorders, Ambulatory Care and Surgery, Rehabilitation
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