National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (3)
- Antimicrobial Stewardship (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Clostridium difficile Infections (13)
- Data (1)
- Genetics (2)
- Healthcare-Associated Infections (HAIs) (11)
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- Mortality (1)
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- Quality of Care (2)
- Risk (2)
- Sepsis (1)
- Shared Decision Making (1)
- Surgery (2)
- Transplantation (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 13 of 13 Research Studies DisplayedAlrawashdeh M, Rhee C, Hsu H
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
The authors sought to examine the association between value-based incentive program (VBIP) implementation and health care facility-onset Clostridioides difficile infection (HO-CDI) rates. Their study evaluated HO-CDI rates among adults hospitalized at acute-care hospitals from January 2013 to March 2019. They found that, in this study, VBIP implementation was associated with improvements in HO-CDI rates, independent of CDI testing method. They recommended that future research focus on elucidating the specific processes that contributed to improvement in HO-CDI rates to inform the design of future VBIP interventions.
AHRQ-funded; HS018414; HS025008.
Citation: Alrawashdeh M, Rhee C, Hsu H .
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
JAMA Netw Open 2021 Oct;4(10):e2132114. doi: 10.1001/jamanetworkopen.2021.32114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Quality of Care
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C .
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Cabral SM, Goodman KE, Blanco N
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
This study’s objective was to determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Adult patients admitted to 3 hospitals in Maryland from 2016 to 2018 were included. Patients with comorbid conditions were assigned using the Elixhauser comorbidity index. Standardized infection rates (SIRs) were computed using current CDC risk adjustment methodology and included the addition of Elixhauser score and individual comorbidities. Hospital 1 had 314 (0.65%) of patients with a HO-CDI, Hospital 2 had 41 (0.47%) with a HO-CDI, and Hospital 3 had 75 (0.26%) with a HO-CDI. Elixhauser score in multivariable regression was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic user, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospitals 1 and 2. Including the Elixhauser score in the risk adjustment model was statistically significant.
AHRQ-funded; HS022291.
Citation: Cabral SM, Goodman KE, Blanco N .
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
Infect Control Hosp Epidemiol 2021 Aug;42(8):955-61. doi: 10.1017/ice.2020.1344..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Risk
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Golob JL, Rao K
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
This paper’s objective is to: 1) review the current thought on risk from antibiotic-resistant organization (ARO) acquisition; 2) review the current understanding on the gut microbiome’s ability to resist colonization with AROs; 3) describe how experimental model systems can test these global initial, global insights to arrive at more granular, mechanistic ones; and 4) suggest a path forward to make further progress in the field. This review is informed from experiences and successes with understanding of the role of the microbiome in mediating risk of Clostridioides difficile infection.
AHRQ-funded; HS027431.
Citation: Golob JL, Rao K .
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
J Infect Dis 2021 Jun 16;223(Suppl 3):S214-S21. doi: 10.1093/infdis/jiab184..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Genetics
Tamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P .
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Shared Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Polage CR, Gyorke CE, Kennedy MA
Overdiagnosis of Clostridium difficile infection in the molecular test era.
This study determined the natural history and need for treatment of patients who are toxin immunoassay negative and polymerase chain reaction (PCR) positive (Tox−/PCR+) for Clostridium difficile Infection ( CDI). They found that among hospitalized adults with suspected CDI, virtually all CDI-related complications and deaths occurred in patients with positive toxin immunoassay test results.
AHRQ-funded; HS022236.
Citation: Polage CR, Gyorke CE, Kennedy MA .
Overdiagnosis of Clostridium difficile infection in the molecular test era.
JAMA Intern Med 2015 Nov;175(11):1792-801. doi: 10.1001/jamainternmed.2015.4114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Genetics
Slayton RB, Toth D, Lee BY
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
The researchers analyzed data from CDC's National Healthcare Safety Network and Emerging Infections Program to project the number of health care-associated infections (HAIs) from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. They found that, with effective action now, more than half a million antibiotic-resistant HAIs could be prevented over 5 years and that a coordinated approach to interrupting transmission is more effective than historical independent facility-based efforts.
AHRQ-funded; HS023317.
Citation: Slayton RB, Toth D, Lee BY .
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
MMWR Morb Mortal Wkly Rep 2015 Aug 7;64(30):826-31.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Safdar N, Perencevich E
Crossing the quality chasm for Clostridium difficile infection prevention.
The author comments on a new population-based cohort study (Daneman, et al.) in the same journal issue on the association of hospital prevention processes and patient risk factors with the risk of Clostridium difficile infection. She concludes that the findings of the study are important and should serve as a wake-up call for institutions to participate actively in assessing and evaluating implementation of and adherence to CDI prevention practices.
AHRQ-funded; HS023791.
Citation: Safdar N, Perencevich E .
Crossing the quality chasm for Clostridium difficile infection prevention.
BMJ Qual Saf 2015 Jul;24(7):409-11. doi: 10.1136/bmjqs-2015-004344..
Keywords: Clostridium difficile Infections, Risk, Healthcare-Associated Infections (HAIs), Prevention
Pakyz AL, Patterson JA, Motzkus-Feagans C
Performance of the present-on-admission indicator for Clostridium difficile infection.
The researchers compared performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data to a present on- admission indicator with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68 percent) and high specificity (93 percent); for community-onset, sensitivity and specificity were high (both 85 percent).
AHRQ-funded; HS018578.
Citation: Pakyz AL, Patterson JA, Motzkus-Feagans C .
Performance of the present-on-admission indicator for Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jul;36(7):838-40. doi: 10.1017/ice.2015.63..
Keywords: Clostridium difficile Infections, Patient Safety, Healthcare-Associated Infections (HAIs), Data
Abdelsattar ZM, Krapohl G, Alrahmani L
Postoperative burden of hospital-acquired Clostridium difficile infection.
This study of 35,363 surgical patients found that 0.51 percent developed a clostridium difficile infection (CDI), with the highest rates occurring after lower-extremity amputation, bowel resection or repair, and gastric or esophageal operations. Post-operative CDI was also associated with higher rates of extended length of stay, emergency room presentations, and readmissions.
AHRQ-funded; HS000053
Citation: Abdelsattar ZM, Krapohl G, Alrahmani L .
Postoperative burden of hospital-acquired Clostridium difficile infection.
Infect Control Hosp Epidemiol. 2015 Jan;36(1):40-6. doi: 10.1017/ice.2014.8..
Keywords: Clostridium difficile Infections, Patient Safety, Surgery, Hospitalization
Abdelsattar ZM, Krapohl G, Alrahmani L
Postoperative burden of hospital-acquired Clostridium difficile infection.
The researchers studied clostridium dificile infection (CDI) across diverse surgical settings. They found that incidence of postoperative CDI varied by surgical procedure and was associated with higher rates of extended length of stay, emergency room presentations, and readmissions, placing a potentially preventable burden on hospital resources.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Krapohl G, Alrahmani L .
Postoperative burden of hospital-acquired Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jan;36(1):40-6. doi: 10.1017/ice.2014.8.
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Keywords: Surgery, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Adverse Events, Hospitals