National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Behavioral Health (1)
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- Chronic Conditions (1)
- Healthcare Cost and Utilization Project (HCUP) (4)
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- Healthcare Delivery (1)
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- (-) Hospital Readmissions (11)
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- (-) Medicaid (11)
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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 11 of 11 Research Studies DisplayedCollins CR, Abel MK, Shui A
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
This study aimed to assess where the largest opportunities for care improvement lay with the bundled payment reimbursement model and how best to identify patients at high risk of suffering costly complications, including hospital readmission. The authors used a cohort of patients from 2014 and 2016 who met inclusion criteria for the Major Bowel Bundled Payment Program and performed a cost analysis to identify opportunities for improved care efficiency. Using the results, they identified readmissions as a target for improvement and then assessed whether the American College of Surgeons' National Surgical Quality Improvement Program surgical risk calculator (ACS NSQIP SRC) could accurately identify patients within the bundled payment population who were at high risk of readmission using a logistic regression model. Patients who were readmitted within 90-days post-surgery were 2.53 times more likely to be high-cost (>$60,000) then non-readmitted patients. However, the ACS NSQIP SRC did not accurately predict patients at high risk of readmission within the first 30 days post-surgery.
AHRQ-funded; HS024532.
Citation: Collins CR, Abel MK, Shui A .
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
Perioper Med 2022 Dec 9;11(1):54. doi: 10.1186/s13741-022-00286-9..
Keywords: Provider Performance, Payment, Hospital Readmissions, Quality Improvement, Quality of Care, Surgery, Medicare, Medicaid
Bucholz EM,, Schuster MA, Toomey SL
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
This study examined trends in 30-day readmission rates for Medicaid and privately insured pediatric patients from 2010 to 2017. The HCUP Nationwide Readmissions Database was used to compare hospital-level risk-adjusted readmission rates. Higher readmission rates were found for Medicaid beneficiaires compared to privately insured pediatric patients during the time period.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM,, Schuster MA, Toomey SL .
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2020-0270..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Health Insurance, Medicaid, Hospitals
Angraal S, Khera R, Zhou S
Trends in 30-day readmission rates for Medicare and non-Medicare patients in the era of the Affordable Care Act.
In this study the investigators we assessed trends in all-cause readmission rates for 1 of the 3 HRRP conditions or conditions not targeted by the HRRP in age-insurance groups defined by age group (>/=65 years or <65 years) and payer (Medicare, Medicaid, or private insurance). The investigators concluded that there appeared to be a systematic improvement in readmission rates for patient groups beyond the population of fee-for-service, older, Medicare beneficiaries included in the HRRP.
AHRQ-funded; HS022882.
Citation: Angraal S, Khera R, Zhou S .
Trends in 30-day readmission rates for Medicare and non-Medicare patients in the era of the Affordable Care Act.
Am J Med 2018 Nov;131(11):1324-31.e14. doi: 10.1016/j.amjmed.2018.06.013..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Medicaid, Medicare
Casucci S, Lin L, Hewner S
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
The purpose of this study was to demonstrate how observational causal inference methods can generate insights into the impact of chronic disease combinations on patients' 30-day hospital readmissions. The investigators concluded that multi-hypothesis causal analysis, a new methodological tool, generates meaningful insights from health care claims data, guiding the design of care and intervention programs.
AHRQ-funded; HS022575.
Citation: Casucci S, Lin L, Hewner S .
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
J Am Med Inform Assoc 2018 Jun;25(6):670-78. doi: 10.1093/jamia/ocx141.
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Keywords: Chronic Conditions, Hospital Readmissions, Medicaid, Hospitals
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
Berry SA, Fleishman JA, Moore RD
AHRQ Author: Fleishman JA
Thirty-day hospital readmissions for adults with and without HIV infection.
This study compared 30-day readmission rates by HIV status in a multi-state sample with planned subgroup comparisons by insurance and diagnostic categories. After adjustment for age, gender, race, insurance, and diagnostic category, HIV infection was associated with 1.5 times higher odds of readmission. Predicted, adjusted readmission rates were higher for persons living with HIV within every insurance category, including Medicaid.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Moore RD .
Thirty-day hospital readmissions for adults with and without HIV infection.
HIV Med 2016 Mar;17(3):167-77. doi: 10.1111/hiv.12287.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Human Immunodeficiency Virus (HIV), Hospital Readmissions, Medicaid, Medicare
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
Jung HY, Trivedi AN, Grabowski DC
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
The objective of this study was to conduct an early evaluation of an innovative program that coordinates benefits for elderly dual eligibles. The authors found no statistically significant effect of senior care options on rehospitalization. They concluded that coordinating the financing and delivery of services through an integrated managed program may not sufficiently address the problems of inefficiency and fragmentation in care for hospitalized dual eligible enrollees.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
Am J Manag Care 2015 Oct;21(10):711-7.
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Keywords: Healthcare Delivery, Care Management, Medicaid, Medicare, Hospital Readmissions
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health
Trudnak T, Kelley D, Zerzan J
AHRQ Author: Jiang HJ
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
The authors characterized acute care hospital admissions and thirty-day readmissions in the Medicaid population through a retrospective analysis in nineteen states. They found that Medicaid readmissions were both prevalent and costly, and that they represented 12.5 percent of Medicaid payments for all hospitalizations, with the most prevalent diagnostic categories being mental and behavioral disorders and diagnoses related to pregnancy, childbirth, and their complications.
AHRQ-authored; AHRQ-funded; 29020090015C.
Citation: Trudnak T, Kelley D, Zerzan J .
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
Health Aff 2014 Aug;33(8):1337-44. doi: 10.1377/hlthaff.2013.0632.
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Keywords: Healthcare Costs, Hospitalization, Medicaid, Hospital Readmissions
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