National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- Antibiotics (2)
- Asthma (1)
- Brain Injury (1)
- Burnout (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (2)
- Case Study (5)
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- COVID-19 (1)
- Critical Care (1)
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- Family Health and History (1)
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- Healthcare-Associated Infections (HAIs) (1)
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- Health Insurance (1)
- Heart Disease and Health (1)
- Hepatitis (1)
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- Imaging (1)
- Infectious Diseases (3)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (10)
- Labor and Delivery (4)
- Lifestyle Changes (1)
- Low-Income (1)
- Maternal Care (2)
- Medicaid (3)
- Medical Errors (1)
- Medication (5)
- Medication: Safety (1)
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- Neonatal Intensive Care Unit (NICU) (11)
- Neurological Disorders (1)
- (-) Newborns/Infants (45)
- Nursing (2)
- Nutrition (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (4)
- Patient-Centered Healthcare (2)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (7)
- Pneumonia (1)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (6)
- Prevention (1)
- Provider (2)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Quality Improvement (2)
- Quality Indicators (QIs) (2)
- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Respiratory Conditions (5)
- Risk (2)
- Screening (1)
- Sepsis (1)
- Shared Decision Making (2)
- Simulation (1)
- Stress (1)
- Substance Abuse (1)
- Surgery (2)
- Teams (2)
- Transitions of Care (2)
- Transplantation (1)
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- Urinary Tract Infection (UTI) (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 45 of 45 Research Studies DisplayedMurosko D, Passerella M, Lorch S
Racial segregation and intraventricular hemorrhage in preterm infants.
Intraventricular hemorrhage (IVH) disproportionately affects black neonates. Other conditions that are more common in black neonates, including low birth weight and preterm delivery, have been linked with residential racial segregation (RRS). In this study, the authors investigated the association between RRS and IVH. The investigators concluded that RRS was associated with an increased risk of IVH in preterm neonates, but the effect size varied by race. They indicated that this association persisted after balancing for community factors and birth weight, representing a novel risk factor for IVH.
AHRQ-funded; HS018661.
Citation: Murosko D, Passerella M, Lorch S .
Racial segregation and intraventricular hemorrhage in preterm infants.
Pediatrics 2020 Jun;145(6):e20191508. doi: 10.1542/peds.2019-1508..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, Adverse Events
Hansen JE, Brown DW, Hanke SP
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
This study examined trends in the routine use of angiotension-converting enzyme inhibitors (ACEI) during palliation of hypoplastic left heart syndrome, which is considered controversial. The authors used patients enrolled in the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry from 2008 to 2016 who had been prescribed ACEI between stage 1 palliation (stage I Norwood procedure) discharge and stage 2 palliation (stage II superior cavopulmonary anastomosis procedure) admission. ACEI prescriptions declined from 45% in the pre-2010 period to 36.8% from 2011 to 2016. No difference was found in interstage mortality, change in atrioventricular valve regurgitation, or change in ventricular dysfunction between groups. Atrioventricular septal defect, and preoperative mechanical ventilation were associated with increased ACEI prescription.
AHRQ-funded; HS021114.
Citation: Hansen JE, Brown DW, Hanke SP .
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
J Am Heart Assoc 2020 May 18;9(10):e014823. doi: 10.1161/jaha.119.014823..
Keywords: Newborns/Infants, Medication, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Registries, Quality Improvement, Quality of Care
Herrick HM, Lorch S, Hsu JY
Impact of flow disruptions in the delivery room.
The goal of this study was to identify the impact of flow disruptions during neonatal resuscitation and to determine their association with key process and outcome measures. Delivery-room resuscitations of neonates less 32 weeks gestational age were video recorded for observation. Results showed that flow disruptions occurred frequently during neonatal resuscitation and recommendations included measuring flow disruptions as a feasible method to assess the impact of human factors in the delivery room and to identify modifiable factors and practices to improve patient care.
AHRQ-funded; HS023538; HS026491; HS026625; HS023806.
Citation: Herrick HM, Lorch S, Hsu JY .
Impact of flow disruptions in the delivery room.
Resuscitation 2020 May;150:29-35. doi: 10.1016/j.resuscitation.2020.02.037.
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Keywords: Workflow, Labor and Delivery, Newborns/Infants, Patient Safety, Healthcare Delivery, Quality Improvement, Quality of Care
Henry MK, Feudtner C, Fortin K
Occult head injuries in infants evaluated for physical abuse.
Abusive head injuries in infants may be occult but clinically or forensically important. Data conflict regarding yield of neuroimaging in detecting occult head injuries in infants evaluated for physical abuse, with prior studies identifying yields of 4.3-37.3 %. The objectives of this study were (1) To quantify yield of computed tomography or magnetic resonance imaging in identification of occult head injuries in infants with concerns for physical abuse and (2) To evaluate risk factors for occult head injuries.
AHRQ-funded; HS024194.
Citation: Henry MK, Feudtner C, Fortin K .
Occult head injuries in infants evaluated for physical abuse.
Child Abuse Negl 2020 May;103:104431. doi: 10.1016/j.chiabu.2020.104431..
Keywords: Newborns/Infants, Brain Injury, Domestic Violence, Imaging, Diagnostic Safety and Quality, Injuries and Wounds
Sherman JP, Hedli LC, Kristensen-Cabrera AI
Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth.
There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. In this study, the investigators employed design thinking methodology to understand how the design of labor and delivery units impacted safety and identified spaces and systems where improvements are needed.
AHRQ-funded; HS023506.
Citation: Sherman JP, Hedli LC, Kristensen-Cabrera AI .
Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth.
Am J Perinatol 2020 May;37(6):638-46. doi: 10.1055/s-0039-1685494..
Keywords: Labor and Delivery, Pregnancy, Patient Safety, Maternal Care, Women, Newborns/Infants
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Beam K, Wojcik MH, Agrawal PB
Prenatal diagnosis of a ventral abdominal wall defect.
This paper is a case study describing an infant diagnosed prenatally with fetal ultrasonography with multiple abnormalities including a ventral abdominal wall defect and confirmed herniation of the liver with the portal vein extending outside the abdomen, stomach, small bowel, and majority of the large bowel without an overlying membrane. The kidneys were enlarged as well. Multiple surgeries were performed. Ultimately the infant died 38 days after birth.
AHRQ-funded; HS000063.
Citation: Beam K, Wojcik MH, Agrawal PB .
Prenatal diagnosis of a ventral abdominal wall defect.
Neoreviews 2020 Apr;21(4):e286-e92. doi: 10.1542/neo.21-4-e286..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Case Study
Pfeifer E, Lozovatsky M, Abraham J
Effect of an alternative newborn naming strategy on wrong-patient errors: a quasi-experimental study.
Newborns are often assigned temporary names at birth. Temporary newborn names-often a combination of the mother's last name and the newborn's gender-are vulnerable to patient misidentification due to similarities with other newborns or between a mother and her newborn. In this study, the investigators developed and implemented an alternative distinct naming strategy, and then compared its effectiveness on reducing the number of wrong-patient orders with the standard distinct naming strategy.
AHRQ-funded; HS025443.
Citation: Pfeifer E, Lozovatsky M, Abraham J .
Effect of an alternative newborn naming strategy on wrong-patient errors: a quasi-experimental study.
Appl Clin Inform 2020 Mar;11(2):235-41. doi: 10.1055/s-0040-1705175..
Keywords: Newborns/Infants, Medical Errors, Adverse Events, Patient Safety
Neu M, Klawetter S, Greenfield JC
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Family-centered care (FCC) in neonatal intensive care units (NICUs) was initiated in 1992 to promote a respectful response to individual family needs and support parental participation in care and decision-making for their infants. Although benefits of FCC have been reported, changes in the maternal experience in the NICU are unknown. The purpose of this study was to compare mothers' experiences in NICUs where FCC is the standard of care and to compare these with the experiences of mothers 2 decades ago.
AHRQ-funded; HS026370.
Citation: Neu M, Klawetter S, Greenfield JC .
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Adv Neonatal Care 2020 Feb;20(1):68-79. doi: 10.1097/anc.0000000000000671.
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Keywords: Newborns/Infants, Patient-Centered Healthcare, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Caregiving, Shared Decision Making, Patient Experience, Patient and Family Engagement
Haidari ES, Lee HC, Illuzzi JL
Utility of birth certificate data for evaluating hospital variation in admissions to NICUs.
Efforts to study potential overuse of NICU admissions and hospital variation in practice are often hindered by a lack of an appropriate data source. In this study, the investigators examined the concordance of hospital-level NICU admission rates between birth certificate data and California Children's Services (CCS) data to inform the utility of birth certificate data in studying hospital variation in NICU admissions.
AHRQ-funded; HS023801.
Citation: Haidari ES, Lee HC, Illuzzi JL .
Utility of birth certificate data for evaluating hospital variation in admissions to NICUs.
Hosp Pediatr 2020 Feb;10(2):190-94. doi: 10.1542/hpeds.2019-0116..
Keywords: Newborns/Infants, Hospitalization, Hospitals
Milstone AM, Voskertchian A, Koontz DW
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
This study examined the effect of treating parents of neonates in the intensive care unit (NICUs) with intranasal mupirocin and topical chlorhexidine compared with a placebo treatment and whether it reduces transmission of Staphlyococcus aureus to their babies. A double-blind randomized trial was conducted at 2 tertiary NICUs in Baltimore, MD from November 2014 to December 2018. Parents were given intranasal treatments for 5 days. Of the intervention group 13 of 89 neonates acquired S aureus, and in the control group 29 of 101 neonates acquired S aureus with the same strain as their parents. The results showed a significant reduction in transmission.
AHRQ-funded; HS022872.
Citation: Milstone AM, Voskertchian A, Koontz DW .
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
JAMA 2020 Jan;323(4):295-386. doi: 10.1001/jama.2019.20785..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Trudnak Fowler T, Fairbrother G, Owens P
AHRQ Author: Owens P
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
The researchers used HCUP data to examine trends from 2002 through 2009 in complicated newborn hospital stays, and to explore the relationship between expected sources of payment and reasons for hospitalizations. They concluded that state Medicaid programs are paying for an increasing proportion of births and costly complicated births, and they suggested that policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.
AHRQ-authored.
Citation: Trudnak Fowler T, Fairbrother G, Owens P .
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
Medicare Medicaid Res Rev 2014;4(4). doi: 10.5600/mmrr.004.04.a03.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Newborns/Infants
Profit J, Sharek PJ, Amspoker AB
Burnout in the NICU setting and its relation to safety culture.
The objectives of this study are three-fold: to test the psychometric properties of a brief four-item burnout scale; to provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types; and to examine the relationships between caregiver burnout and patient safety culture. The authors found that NICU caregiver burnout appears to have 'climate-like' features, is prevalent, and is associated with lower perceptions of patient safety culture.
AHRQ-funded; HS014246.
Citation: Profit J, Sharek PJ, Amspoker AB .
Burnout in the NICU setting and its relation to safety culture.
BMJ Qual Saf 2014 Oct;23(10):806-13. doi: 10.1136/bmjqs-2014-002831.
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Keywords: Provider: Health Personnel, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care
Lorch SA, Passarella M, Zeigler A
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
The authors examined the viability of a hospital readmission quality metric for infants requiring neonatal intensive care. They found that the California cohort showed significant variation in hospital-level readmission rates, supporting the premise that readmission rates of prematurely born infants may reflect care quality. However, state data did not include term and early term infants requiring neonatal intensive care, and there were extensive missing data in the few states with sufficient information on managed care patients to calculate state-level measures. They concluded that constructing a valid readmission measure for NICU care across diverse states and regions requires improved data collection.
AHRQ-funded; HS018661; HS020508.
Citation: Lorch SA, Passarella M, Zeigler A .
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S47-53. doi: 10.1016/j.acap.2014.06.010.
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Keywords: Neonatal Intensive Care Unit (NICU), Newborns/Infants, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
Salihu HM, Salemi JL, Nash MC
Assessing the economic impact of paternal involvement: a comparison of the generalized linear model versus decision analysis trees.
The authors illustrated a methodological comparison of decision analysis modeling and generalized linear modeling (GLM) techniques using a case study that assesses the cost-effectiveness of potential father involvement interventions. They found that lack of paternal involvement was associated with higher rates of preterm birth, small-for-gestational age, and infant morbidity and mortality, concluding that healthcare costs could be significantly reduced through enhanced father involvement during pregnancy.
AHRQ-funded; HS019997.
Citation: Salihu HM, Salemi JL, Nash MC .
Assessing the economic impact of paternal involvement: a comparison of the generalized linear model versus decision analysis trees.
Matern Child Health J 2014 Aug;18(6):1380-90. doi: 10.1007/s10995-013-1372-0.
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Keywords: Family Health and History, Newborns/Infants, Outcomes, Pregnancy, Case Study, Shared Decision Making
Schiltz NK, Finkelstein Rosenthal B, Crowley MA
Rehospitalization during the first year of life by insurance status.
The authors assessed the association of insurance status on infant rehospitalization in a population-based setting. They found that Medicaid coverage and being uninsured were strong predictors of rehospitalizations, with Medicaid bearing a disproportionate share of the economic burden. Normal birth weight infants had the lowest risk. They further found that jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
AHRQ-funded; HS000059.
Citation: Schiltz NK, Finkelstein Rosenthal B, Crowley MA .
Rehospitalization during the first year of life by insurance status.
Clin Pediatr 2014 Aug;53(9):845-53. doi: 10.1177/0009922814536924.
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Keywords: Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Newborns/Infants, Medicaid, Newborns/Infants
Bennett WE, Jr., Hendrix KS, Thompson-Fleming RT
Early cow's milk introduction is associated with failed personal-social milestones after 1 year of age.
The researchers used a novel computerized decision support system to gather data from multiple general pediatrics offices.They found an association between the introduction of cow's milk before 1 year of age and the rate of delayed developmental milestones after 1 year of age, adding strength to the recommendations from the AAP and IOM to delay cow's milk introduction until after 1 year of age.
AHRQ-funded; HS017939; HS018453; HS020640.
Citation: Bennett WE, Jr., Hendrix KS, Thompson-Fleming RT .
Early cow's milk introduction is associated with failed personal-social milestones after 1 year of age.
Eur J Pediatr 2014 Jul;173(7):887-92. doi: 10.1007/s00431-014-2265-y.
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Keywords: Clinical Decision Support (CDS), Disabilities, Health Information Technology (HIT), Newborns/Infants, Nutrition
Palmsten K, Huybrechts KF, Kowal MK
Validity of maternal and infant outcomes within nationwide Medicaid data.
The researchers aimed to assess the validity of preeclampsia, congenital cardiac malformations, and persistent pulmonary hypertension of the newborn diagnoses in the U.S. Medicaid Analytic eXtract (MAX), a database that may be useful for perinatal research. The positive predictive values were conservative, particularly when restricting to infants not transferred to another facility shortly after birth because only records from a single hospitalization were reviewed.
AHRQ-funded; HS018533
Citation: Palmsten K, Huybrechts KF, Kowal MK .
Validity of maternal and infant outcomes within nationwide Medicaid data.
Pharmacoepidemiol Drug Saf 2014 Jun;23(6):646-55. doi: 10.1002/pds.3627..
Keywords: Newborns/Infants, Maternal Care, Outcomes, Medicaid
Anand V, Downs SM, Bauer NS
Prevalence of infant television viewing and maternal depression symptoms.
This study evaluated how the risk of very early TV viewing by infants relates to the mother’s reported symptoms of depression. It found that TV viewing by infants increased by almost 50 percent with maternal report of depression symptoms.
AHRQ-funded; HS018453; HS017939
Citation: Anand V, Downs SM, Bauer NS .
Prevalence of infant television viewing and maternal depression symptoms.
J Dev Behav Pediatr. 2014 Apr;35(3):216-24. doi: 10.1097/dbp.0000000000000035..
Keywords: Newborns/Infants, Depression, Risk, Lifestyle Changes