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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.
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1 to 4 of 4 Research Studies DisplayedLikosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Kim KD, Funk RJ, Hou H
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
The purpose of this study was to examine the relationship between care fragmentation and total spending for durable left ventricular assisted device (LVAD) implant, and whether this relationship is mediated by infections. The researchers developed a measure of care fragmentation based on the number of shared medical professionals providing care to 4,987 Medicare beneficiaries undergoing LVAD implantation. The study found that the indirect effect of care fragmentation, through infections, was positive and statistically significant. The researchers concluded that higher care fragmentation associated with durable LVAD implantation is related with a greater incidence of infections and higher Medicare beneficiary payments.
AHRQ-funded; HS026003.
Citation: Kim KD, Funk RJ, Hou H .
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
Circ Cardiovasc Qual Outcomes 2022 Sep;15(9):e008592. doi: 10.1161/circoutcomes.121.008592..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Costs, Healthcare-Associated Infections (HAIs), Medicare, Medical Devices, Healthcare Delivery
Pokorney SD, Miller AL, Chen AY
Implantable cardioverter-defibrillator use among Medicare patients with low ejection fraction after acute myocardial infarction.
This study examined Implantable Cardioverter-Defibrillator (ICD) implantation rates and associated mortality among older MI patients with low ejection fraction (EF). It found that fewer than 1 in 10 eligible patients with low EF received an ICD within 1 year after MI, although ICD implantation was associated with lower risk-adjusted mortality at 2 years.
AHRQ-funded; HS021092.
Citation: Pokorney SD, Miller AL, Chen AY .
Implantable cardioverter-defibrillator use among Medicare patients with low ejection fraction after acute myocardial infarction.
JAMA 2015 Jun 23-30;313(24):2433-40. doi: 10.1001/jama.2015.6409..
Keywords: Medical Devices, Heart Disease and Health, Medicare
Setoguchi SR, Warner Stevenson L, Stewart GC
Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure.
This study assessed the potential contribution of unmeasured general health status to patient selection in assessments of implantable cardioverter-defibrillator (ICD) therapy. In a group of heart failure patients, those who received ICD therapy were younger and had lower ejection fraction and more cardiac admissions to hospital but fewer non-cardiac admissions. The lower risks of measured outcomes likely reflect unmeasured differences in comorbidity and frailty.
AHRQ-funded; 29020050016I; HS017731
Citation: Setoguchi SR, Warner Stevenson L, Stewart GC .
Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure.
BMJ. 2014 May 8;348:g2866. doi: 10.1136/bmj.g2866..
Keywords: Medical Devices, Outcomes, Registries, Heart Disease and Health, Medicare